chiro school using stethoscopes
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The answer to your question is yes. Chiropractors do receive training in using stethescopes along with many other procedures you might not otherwise think are pertinent to neuromusculoskeletal care. Chiropractic colleges, despite what some critics may say, train chiropractors to be primary care physicians. Chiropractors are trained to do level four examinations (as many insurance companies refer to them) which are some of the highest level examinations there are. Chiropractors are trained to do neurologic, orthopedic and chiropractic exams, and should do them on every patient. In addition chiropractors are trained extensively in the interpretation of radiographs (ie x-rays, and even cat scans and mri's.) The fact is more and more chiropractors are being staffed by hospitals and working in interdisciplinary settings and as such are very qualified. Also if you would just take a cursory look at chiropractic curriculums I think you will be quit suprised at not only the amount of course work but the variety and range of study that is taught. In fact, in certain chiropractic schools such as western states, chiropractors are trained in minor surgery and child birth. Although chiropractors do not prescribe medication, they are charged with the right/responsibility of differential diagnosis on every patient. (As opposed to a physical therapist-who can not take patients off the street, but must have them referred). Also, bear in mind that chiropractic students spend alot of time learning when to recognize when chiropractic treatment is contraindicated and when to refer out to other specialists. So yes, chiropractors are certainly trained to use stethescopes.
Unfortunately that isn't quite right...primarily because to correctly use a stethescope one must have adequate skills in evaluating pathology...and not even 4th year medical students have good enough ears...so how can a chiropractor or chiropractic student?
While I respect the skill of a chiropractor in the realm of manual medicine, a stethescope is not likely the favored tool. The problem is WHO is teaching the chiropractic student to listen...and from what patient pool? It takes years of listening to "sick vs not sick" to feel comfortable.
So can chiropractic students hear breath sounds...of course. But why listen? If you listen you are holding yourself to the "standard of care" which is NOT a chiropractor. If you miss something, you can be held accountable. Why do that?
As for "child birth"...come on. Think about it for a moment...do you really want the medicolegal risk or responsibility? Remember, there is a "standard of care".
While I respect the skill of a chiropractor in the realm of manual medicine, a stethescope is not likely the favored tool. The problem is WHO is teaching the chiropractic student to listen...and from what patient pool? It takes years of listening to "sick vs not sick" to feel comfortable.
So can chiropractic students hear breath sounds...of course. But why listen? If you listen you are holding yourself to the "standard of care" which is NOT a chiropractor. If you miss something, you can be held accountable. Why do that?
As for "child birth"...come on. Think about it for a moment...do you really want the medicolegal risk or responsibility? Remember, there is a "standard of care".
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Well your commentary is not entirely correct. First of all certain chiropractic colleges now have hospital affiliations, such as New York Chiropractic College with Bethesda Naval hospital. Its not just an affiliation but rather certain chiropractic students may take part in a "residency" and do rounds with the interns at the hospital. While this is not the majority of chiropractic schools, it is changing. And because chiropractic schools recognize that their students skills will now be held up to a high level of scrutiny they are taking measures to ensure that their students are prepared. Also, chiropractors do spend atleast a year and a half in a clinic. In these clinics, chiropractors have to evaluate and diagnose many patients who have walked in off the street, many times they are undiagnosed by a medical doctor. Part of the very lengthy exam that these clinicians must perform is to ascoltate with a stethescope. While I agree with you that their training in this particular area is probably not as extensive as say a cardiologist, I wouldnt automatically assume that they are worse than a family practitioner. Also, where you attend chiropractic school makes a huge huge difference. I think it may shock you to see quit how proficient todays chiropractors are in diagnosing non nms conditions. Lets also keep in mind that chiropractors must pass licensing exams part 1 2 3 and 4. And much of these exams test standard medical diagnosis and care.
I recognize your concern that many chiropractic schools do not afford their students with enough exposure... which is definitely necessary for the development of skills. But hopefully this continues to change.
I recognize your concern that many chiropractic schools do not afford their students with enough exposure... which is definitely necessary for the development of skills. But hopefully this continues to change.
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Oh come on, I see nurses using stethoscopes daily.....
🙂
🙂
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psisci said:
That made me laugh Psisci , but in seriousness, a good nurse could show a seasoned chiro how to "AUSCULTATE!!!!" correctly any day.
Chirodude- How can you expect to do it if you can't even spell it 😀 You are smoking some serious ganjaweed if you think any chiro can use a stethescope to the degree to which ANY family physician can. So what that a chiro has passed 4 different "CHIROPRACTOR BASED" board exams? Let them challenge the 3 USMLE or COMLEX board exams and then we'll see how versed they are. I have spent 4 years of my life at Bethesda Naval Hospital and never once did I see a chiropractor holding a stethescope. You are trying to influence a group of educated people about a topic you obviously don't know anything about. I think they have a name for people like you.......CULT LEADERS.
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First of all, I am not a chiropractor nor a cult leader. I will be attending new york college of osteopathic medicine this fall. Second of all, if you doubt the fact that chiropractors carry stethescopes in Bethesda naval hospital, you are just flat out wrong. Its not my opinion, its fact. I have a very close relationship with the president of new york chiropractic college and am well aware as to the details of this program. Second of all, its extremely ignorant for you to be talking as though you are fully aware as to what chiropractors know and do not know. Chiropractors are certainly trained in utilizing stethescopes and a variety of other diagnostic tools. Would it suprise you to learn that a study just demonstrated that chiropractors outperformed medical residents in the interpretation of radiographs. Also, chiropractic radiologists (yes there is such a thing) performed just as well as board certified medical radiologists did. This comes as no suprise to anyone who is already familiar with chiropractic school curriculums, only to the ignorant and uninformed. Aside from the m.d. or d.o. degree, chiropractors are the ONLY doctors who are trained as full body physicians and as such are responsible for diagnosing and/or treating a full spectrum of dis-ease. This is unlike podiatrists, dentists, physical therapists, nurse practitioners etc... Yes I am aware that chiropractors do not prescribe medication, but just because their treatment methods are different does not make them any less qualified to identify organic disease. At the Texas Back Institute, a very well known orthopedic institution, chiropractors are first line docs used to rule out pathology. I do not want to debate every issue about chiropractic, it has been done an naseum in this forum. But I just wanted to clear up this young ladys question and to ensure her that in her future career she will be and should be depended upon for much more then "cracking backs".
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skiiboy said:
Wow, so you figure if you just keep stating the same misinformation on different threads in this forum it will suddenly be true?
I'll repost my answer to this bovine scatology to your similar post in another thread.
Once again, do you even read the studies you describe, or do you just guess at what they say? You are nowhere close on these two either (yep - there are two of them!). Here are links to the abstracts: http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=12221360 and http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=7638657.
Dealing with them in order, the first shows that of thirteen people, five MDs and 8 DCs, interrater agreement for DCs was a low as 0.44 (among the five chiropractors not identified as chiropractic radiologists). Now a kappa of 1.0 means complete agreement, and they scored a 0.44 (meaning they agreed on the findings in only 44% of the films). Second, look at the study design itself, 13 people looked at 300 x-rays to detect an abnormality (present in 50 films). So what! I have said that I do not doubt, necessarily, a DCs skill in NMS, but in non-NMS conditions. Besides, with thirteen participants, I really question the power of the study.
And lastly, lets look at some conclusions here.
"The intraobserver agreement showed mean kappas of 0.58, 0.68, and 0.72, respectively. The difference between the chiropractic radiologists and medical radiologists was not significant. However, there was a difference between the chiropractors and the other professional groups. {emphasis added}. "The medical radiologists were more specific than the others." "Good professional relationships between the professions are recommended to facilitate interprofessional consultation in case of doubt by the chiropractors." {emphasis added}.
The second, demonstrated that,
"Post hoc tests (P < 0.05) revealed that skeletal radiologists achieved significantly higher test results than did all other medical groups; that the test results of general medical radiologists and medical radiology residents was significantly higher than those of medical clinicians; that test results of medical students was significantly poorer than that of all other medical groups; that the performance of chiropractic radiologists and chiropractic radiology residents was significantly higher than that of chiropractic clinicians and chiropractic students; that no significant differences was revealed in the mean values of performance of chiropractic clinicians and chiropractic students"
and concluded"These data demonstrate a substantial increase in test results of all radiologists and radiology residents when compared to students and clinicians in both medicine and chiropractic related to the interpretation of abnormal radiographs of the lumbosacral spine and pelvis. Furthermore, the study reinforces the need for radiologic specialists to reduce missed diagnoses, misdiagnoses, and medicolegal complications.
I will grant that chiropractic students did do better than medical students, and that chiropractic radiology residents (who are by definition already practicing chiropractors) did better than radiology residents (not yet licensed). But this study was limited to the reading of lumbar and sacral spine films, hardly the first and last line of diagnostics.
skiiboy said:
And once again, the Texas Back Institute is a chiropractic practice. No one debates that chiropractors believe they can rule out pathology. The question is, does research confirm this ability, and the answer is no.
skiiboy said:
As opposed to the five and a half that a BE/BC FP, internist, or EP does. A year and a half in clinic gives chiropractors roughly the experience level of the average fourth year medical student. If you are saying that a chiropractor can diagnose only as well as a fourth year medical student, we actually agree on something for once.
Unfortunately for your argument, MDs and DOs go on for another 3 years minimum of training after that point.skiiboy said:
That is interesting given that Chiropractic is, by definition, non-surgical care. From http://admissions.palmer.edu/info/whatis.htm "Chiropractors use natural, drugless, non-surgical health care and rely on the body's inherent recuperative abilities." Or is Palmer College just "ignorant to what chiropractors know and do not know"?
- H
BTW - Yes PH, I know I said I'd stay out of these debates, but this guy is such a kook, I can't resist. I can't just let this BS go...
skiiboy said:
Unfortunately for this young lady, youre giving her a distorted view about chiropractic training and abilities. It seems what you state in all your posts about chiropractic are more of what you wish they were rather than the reality. Jesse14, SKIIBOY is quite simply an odd and daffy duck who woddles to his own quack. Be careful, L. 😉
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Lol, I really love how you say I'm wayyy off on my interpretation of the study listed above. In fact my conclusion about chiropractors performing better then residents is indeed true and this study confirms this. You can doubt the validity of the study due to the number of participants, but your skepticism is just that, YOUR SKEPTICISM. Do you somehow proport that this study in any way shows chiropractic in a negative light? Cause if not I do not understand wh you continue to malign chiropractic with these particular issues. The basic premise of the study was overall a positive one. Also you quote :
That is interesting given that Chiropractic is, by definition, non-surgical care. From http://admissions.palmer.edu/info/whatis.htm "Chiropractors use natural, drugless, non-surgical health care and rely on the body's inherent recuperative abilities." Or is Palmer College just "ignorant to what chiropractors know and do not know"?
Are you under the impression that all chiropractic schools are palmer schools? They most certainly are not. In fact there are only 3 Palmer chiropractic schools. I said that Western States - in addition to the traditional chiropractic curriculum does also teach minor surgeries, I believe rectal surgeries although I am not sure. This helps further reinforce my point that which chiropractic school you attend greatly influences the type of chiropractor you will become.
It seems like in all of my past posts, many of you scan for one particular area in which to find some argumentative point and then start debating the intricisies of that one point. While calling me a "quack". This post is one such particular example.
Also I think it is you who believes that typing misinformation over and over again eventually makes it true. Atleast my intentions are to educate, not mislead. You state that the Texas Back Institute is a chiropractic institute. THIS IS COMPLETELY FALSE.
"The Texas Back Institute provides a complete team of highly trained medical professionals, non-surgical treatment protocols and rehabilitation. The professional staff includes board-certified orthopedic surgeons with spine fellowship training, general surgeons, general medicine physicians, internists, chiropractors, physiatrists, pain specialists, exercise physiologists and a team of physical and occupational therapists."
That is interesting given that Chiropractic is, by definition, non-surgical care. From http://admissions.palmer.edu/info/whatis.htm "Chiropractors use natural, drugless, non-surgical health care and rely on the body's inherent recuperative abilities." Or is Palmer College just "ignorant to what chiropractors know and do not know"?
Are you under the impression that all chiropractic schools are palmer schools? They most certainly are not. In fact there are only 3 Palmer chiropractic schools. I said that Western States - in addition to the traditional chiropractic curriculum does also teach minor surgeries, I believe rectal surgeries although I am not sure. This helps further reinforce my point that which chiropractic school you attend greatly influences the type of chiropractor you will become.
It seems like in all of my past posts, many of you scan for one particular area in which to find some argumentative point and then start debating the intricisies of that one point. While calling me a "quack". This post is one such particular example.
Also I think it is you who believes that typing misinformation over and over again eventually makes it true. Atleast my intentions are to educate, not mislead. You state that the Texas Back Institute is a chiropractic institute. THIS IS COMPLETELY FALSE.
"The Texas Back Institute provides a complete team of highly trained medical professionals, non-surgical treatment protocols and rehabilitation. The professional staff includes board-certified orthopedic surgeons with spine fellowship training, general surgeons, general medicine physicians, internists, chiropractors, physiatrists, pain specialists, exercise physiologists and a team of physical and occupational therapists."
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How can a chiropracter perform surgery if they can't prescribe medication? "Let me see Mr. Jones just bite on this leather strap while I perform that hemorrhoidectomy." That is kind of a funny thought. 
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jesse14 said:
The general consensus is yes, you will learn how to use a stethoscope at chiro school. Heck, they let us EMTs use steths 🙂 .
jesse14 said:
I have a good friend that's a Chiro, the only time he uses his stehescope is when he does a DMV physical (for a blood pressure check). Anything else he sends them back to their doctor.
Also, don't pay no mind to skiiboy. He's just on his way to the "Jones Town School of Chiropractic and Osteopathic Medicine" and can't wait to get in the Kool-Aid line.
No there is nothing bad about chiro or osteo school, I felt that jonestown sums up our friend skiiboy quite well.
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This article sums it up well: http://www.chiroweb.com/archives/09/09/20.html
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skiiboy said:
Really? Quote the source. Unlike you, I have read the studies. In the second study there was a finding that "chiropractic radiologists" - who are practicing professionals, read lumbar spine films better than residents - who are by definition still in training. Medical Radiologists read them better than Chiropractic Radiologists - which is "comparing apples to apples" as those two groups are the practicing professionals. Hmm, that doesn't make much for your argument.
skiiboy said:
Which one? The first study (the one with n=13) was pretty clear that chiropractors need over-reads. The second seemed more concerned with proving the need for advanced radiology training regardless of profession. And my "skepticism" is actually a critique of the methodology and findings. I state my concerns clearly, with citations and accurate quotes. I will be very interested in how well this half-hearted research reviewing will serve you next year in school. My bet is not well at all.
skiiboy said:
The "premise" of the study? I think you mean "conclusion" and I think I covered those quite well in my previous post. If you can find different conclusions, feel free to post them.
skiiboy said:
First off, Palmer was the "founder" of chiropractic (and the "fountainhead" of all knowledge
) The system he taught is, by definition, non-surgical. And the fact that there exists this much variation of practice patterns without any cohesive oversight (or even intra-profession agreement as to the scope of practice) is one of my major concerns regarding chiropractic.skiiboy said:
Actually I almost always include your entire post. What I then do is look for areas where you assert "facts" and challenge those assertions with an open methodology, posting links to the sources I use in the dispute. At no time have I ever called you a "quack".
skiiboy said:
What is this - "I know you are but what am I"? Grow up. I provide links to studies, express concerns regarding design, methodologies, or conclusions, in direct response to your assertions. You are certainly free to rebut, point out errors in my assessment, or otherwise add to the discussion - something you have thus far refused to do.
skiiboy said:
Hmm, "non-surgical treatment protocols and rehabilitation" sounds an awful lot like chiropractic to me. As does their employment of chiropractors to perform chiropractic care. Give me one source, other than self promotional materials from TBI, that verifies them as "a very well known orthopedic institution".
- H
Lets start off by saying that im a guy lol 🙂, but i'm still nice!!
I'm upset that everytime i ask a simple question about chiropractic I ALWAYS get hostility and arguments! I just want to know the facts and if certain people (SKIBOY) have an input than i'm more than happy to hear it. Instead, you people argue with him like children. He may be off, i really don't know enough to comment. But wouldn't it be better to simply say where he was right and where he was wrong instead of calling him stupid names that are fit for a grade 2 class. I want to hear all thoughts and facts if people have them, but please just stop the bickering!
Thank you all for your thoughts (expecially SKIBOY)
I'm upset that everytime i ask a simple question about chiropractic I ALWAYS get hostility and arguments! I just want to know the facts and if certain people (SKIBOY) have an input than i'm more than happy to hear it. Instead, you people argue with him like children. He may be off, i really don't know enough to comment. But wouldn't it be better to simply say where he was right and where he was wrong instead of calling him stupid names that are fit for a grade 2 class. I want to hear all thoughts and facts if people have them, but please just stop the bickering!
Thank you all for your thoughts (expecially SKIBOY)
skiiboy said:
FYI, it is legal in 37 states and counting for people to directly access physical therapists. DC students learn when treatment is contraindicated but don't always apply (or remember) what they learned.
To an earlier question...
The standard of care defines practice...if you call yourself a "doctor" and one believes they can care for a patient as their "primary physician" then you will be held to the standard of care of other "primary physicians"...NOT EMT's and NOT NURSES. See what I am getting at. The comparison is not with EMTs or nurses, but rather other physicians in a "primary care setting".
You don't want that type of comparison in a medicolegal forum.
Furthermore, I don't particularly care about chiropractic students at a naval hospital...a DC college in St. Louis threatened a lawsuit to allow DC students to rotate (for a 2 week elective) with medical students at one of my base hospitals in St. Louis (Des Peres Hospital). Walking with a stethescope does not define proper usage.
It is all about number of patients and pathology.
And besides, who really cares?
A DC is a manual medicine specialist...a fine distinction.
When you enter into Medical School...you will understand.
The standard of care defines practice...if you call yourself a "doctor" and one believes they can care for a patient as their "primary physician" then you will be held to the standard of care of other "primary physicians"...NOT EMT's and NOT NURSES. See what I am getting at. The comparison is not with EMTs or nurses, but rather other physicians in a "primary care setting".
You don't want that type of comparison in a medicolegal forum.
Furthermore, I don't particularly care about chiropractic students at a naval hospital...a DC college in St. Louis threatened a lawsuit to allow DC students to rotate (for a 2 week elective) with medical students at one of my base hospitals in St. Louis (Des Peres Hospital). Walking with a stethescope does not define proper usage.
It is all about number of patients and pathology.
And besides, who really cares?
A DC is a manual medicine specialist...a fine distinction.
When you enter into Medical School...you will understand.
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jesse14 said:
The problem is not more information than has been asked, it's incorrect and misleading information that is been given as hard fact that everybody gets fired-up about.
jesse14 said:
That has been tried multiple times, yet some people hold on to their anecdotal evidence as hard science and preach it as such.
We all should be saying thanks to those that give their time to provide scientific evidence and systematic evaluation of unproven fact. No one here has a problem with controversial or new avenues of science, just so long that unproven and unsupported claims aren't made that could mislead people.
Skiiboy did a pretty good job in laying out chiropractic education. As far stethoscopes go, Freedom did a good job responding. We do learn quite a bit with concern to using stethoscopes. The difference is medical students listen to pathological hearts all the time. This is something we do not get a whole lot of exposure to as Skiiboy and you have pointed out. We have all kinds of fancy cds and dvds that we go over in class that have all the different pathological sounds, but we cant become a master by listening to audio alone. We do listen to hearts all the time in our internship but most patients arent specifically there for a heart condition. Even so, we do pickup a few with abnormal sounds that do not present with symptoms. As far as standard of care Skiiboy is right that that we have a legal responsibility of differential diagnosis on every patient. The point of using the stethoscope isnt necessarily for a chiropractor to know what all the pathological sounds and how to treat them, but rather to know they arent normal and if they arent normal to refer to the PCP. We are not trying to take over your job as a primary care physician. Its so we can help possibly find a problem directly, or more often than not indirectly, and then send them over to you so you can take care of it. In my years of practice I have picked up a few pathological heart sounds. I have found more bruits as many times we auscultate the carotids on patients that might be receiving cervical spine manipulations. We also take blood pressures, which you know requires the use of a stethoscope. But since we arent exposed to these sounds on a daily basis, we tend you lose what we have learned in school.
So Jesse to answer you question I will tell you its true that chiropractic colleges teach students how to use a stethoscope. Yes chiropractors use a stethoscope in practice but not to the extent that an osteopath physician or medical physician does. We usually do not have patients enter our office with heart conditions or with lung conditions that require us to evaluate them. Most of the time they have already been diagnosed and are being treated by their PCP. We do on occasion have someone present with a NMS condition that also has some other problems that havent yet been diagnosed. I will check them out and let them know they need to see their primary care doctor. In Chiropractic College, you will have to buy a stethoscope. You can buy them wherever you want and most all colleges carry them. They are required, as you will need it for your cardio DX, respiratory DX and for your physical DX classes. You will need it as an intern and will need it to get through comp boards. During the comp boards you will have to take blood pressures and also listen to the heart, lungs, carotids and abdomen on real patients during the practical portions of the exams. You will have to know the proper technique (and yes there is one) and will have to know all the pathological sounds for the circulatory system, lungs and abdomen
So Jesse to answer you question I will tell you its true that chiropractic colleges teach students how to use a stethoscope. Yes chiropractors use a stethoscope in practice but not to the extent that an osteopath physician or medical physician does. We usually do not have patients enter our office with heart conditions or with lung conditions that require us to evaluate them. Most of the time they have already been diagnosed and are being treated by their PCP. We do on occasion have someone present with a NMS condition that also has some other problems that havent yet been diagnosed. I will check them out and let them know they need to see their primary care doctor. In Chiropractic College, you will have to buy a stethoscope. You can buy them wherever you want and most all colleges carry them. They are required, as you will need it for your cardio DX, respiratory DX and for your physical DX classes. You will need it as an intern and will need it to get through comp boards. During the comp boards you will have to take blood pressures and also listen to the heart, lungs, carotids and abdomen on real patients during the practical portions of the exams. You will have to know the proper technique (and yes there is one) and will have to know all the pathological sounds for the circulatory system, lungs and abdomen
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All I have to say is this. Anything but "Lub Dub", and you chiro's who can't seem to spell auscultate better refer the patient to someone else. Because there is no chance in hell that you would know a pathologic murmur from an innocent flow murmur. I hope I get the proviledge of being the expert witness that testifies against the chiro that clears some kid for a sport's physical because they missed the pathologic murmur that coincided with the kids hypertrophic cardiomyopathy. These kids drop dead you know, and when you hang out a shingle calling yourself a physician and advertise for .50 exams, its no doubt some poor Medicaid Mom will come a calling with her unknowingly sick kid. You guys really need to stick to manipulative medicine, otherwise go to real medical school like the rest of us.
If in fact the medical community decided to allow chiro's to challenge the USMLE at a cost of 500 bucks per shot, there would be a lot more money in the pot to reduce costs for 2nd year med students, all the while you wouldn't have to worry about adding any chiros to the ranks of the MD mix!!
If in fact the medical community decided to allow chiro's to challenge the USMLE at a cost of 500 bucks per shot, there would be a lot more money in the pot to reduce costs for 2nd year med students, all the while you wouldn't have to worry about adding any chiros to the ranks of the MD mix!!
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PACtoDOC said:
Geez, i luv you guys.
Wait a minute. "Minor surgery" and "Childbirth" ????? 😱 You gotta be kidding? Show me ONE state that allows chiros to do this. And show me the malpractice carrier that will cover them.
jwk said:Geez, i luv you guys.
Wait a minute. "Minor surgery" and "Childbirth" ????? 😱 You gotta be kidding? Show me ONE state that allows chiros to do this. And show me the malpractice carrier that will cover them.
haha
PACtoDOC said:
I understand what you are saying but as far as HCM is concerned, isnt the condition often misdiagnosed? That is its diagnosed most commonly as asthma or specifically athletically induced asthma. According to the HCMA, 50% of all cases on file are misdiagnosed as something other than the disease. Foughfyr has brought up his concerns of chiropractors doing sports physicals and possibly missing this condition. I have to ask, if 50% of the cases are misdiagnosed, presumably by medical doctors, are you going to jump on the witness stand and fry them too? If nurses and PAs are also allowed to do these physicals, then why shouldnt a DC be allowed? After all, our training in my opinion surpasses theirs. Your argument shouldnt just single out DCs if your main concern is for the welfare of the athlete.
My goal in life is not to do sport physicals and honestly I do not do many sports physicals. I will agree that there are chiropractors that do allot of these physicals that really shouldnt be doing them. The chiropractors that that do post graduate education and have earned a diplomat in sports medicine are trained to specifically rule out this condition. Those doctors should have the right to perform these physicals.
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I am trying to be polite by showing the most extreme scenario possible for a misdiagnosis, but there are plenty of common things in between that serious of a disorder and not so serious disorders that chiros simply don't see enough of to comfortably diagnose. Do you guys even have an ophthalmoscope in your offices, and would you know how to use one? You can't diagnose common retinal issues even without one you know.
And dude, Backtalk, I often have respect for many of the things you say on this forum, but you are wrong to think that a chiro knows more than a PA in ANY subject except neuromusculoskeletal medicine. I have been through PA school and now medical school and I can promise you this without being biased. I have several close friends who are chiro's and just their fund of MEDICAL knowledge is not where mine is or was as a PA. PA's go through 2-3 thousand hours of medical clinical hours. You guys barely step foot in a hospital or a medical clinic.
And just because someone is a Sport's Medicine Chiro does not mean they are competent to do Sport's Physicals. Sports Physicals cross the gammut of full spectrum medicine.
And dude, Backtalk, I often have respect for many of the things you say on this forum, but you are wrong to think that a chiro knows more than a PA in ANY subject except neuromusculoskeletal medicine. I have been through PA school and now medical school and I can promise you this without being biased. I have several close friends who are chiro's and just their fund of MEDICAL knowledge is not where mine is or was as a PA. PA's go through 2-3 thousand hours of medical clinical hours. You guys barely step foot in a hospital or a medical clinic.
And just because someone is a Sport's Medicine Chiro does not mean they are competent to do Sport's Physicals. Sports Physicals cross the gammut of full spectrum medicine.
PACtoDOC said:
Yes, I do have an ophthalmoscope and an otoscope and have been trained on using both of them. You, like many here, underestimate the education a chiropractor receives. You probably dont know we take EENT courses in college. You probably think all we do is look for imaginary subluxations. You probably have a heard time comprehending our education because we do not utilize drugs or surgery. This doesnt change our knowledge of how the human body works and what diseases its susceptible to. What about you? Do you even know how to read an x-ray?
I honestly do not know what it takes to be a PA. I didnt say it was a fact that we are more educated than physician assistants are. I stated it was my opinion. I may be wrong and many times on this forum I have changed my position when presented with the facts. So in other words, since you have a few friends who are chiropractors that lack in the medical knowledge department, this has resulted in your conclusion that physician assistants know more than chiropractors. I know of PAs and many physicians that are total idiots, I dont draw my conclusions from a select group of individuals.
Just because you went to school to be a physician assistant doesnt mean you are competent to do sport physicals either.
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Sample course schedule in diagnostics: http://www.bridgeport.edu/pages/2571.asp
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You guys are like salmon swimming upstream. Its not me you need to convince, but the rest of the world. You will never be accepted as being competent medical providers because you are not taught by anyone with a medical doctorate. Were all chiros trained by medical doctors, I could understand why these courses in your curriculum are valid. At least PA's are taught how to practice medicine by physicians. You guys are not physicians, and you have no business delving into the medical issues of patients that do not strictly relate to neuromusculoskeletal medicine. But you know this, and the only reason you are arguing the point is because you are trying to convince yourself of this fact. You will simply never overcome the justifiable prejudice that surrounds your profession.
Its not me you need to convince, but the rest of the world.
Most of the world has already accepted chiropractors and the treatments they offer. You're right, its not you we need to convince or any other medical doctors, it's the public. I think we have already done that.
You will never be accepted as being competent medical providers because you are not taught by anyone with a medical doctorate.
Again, we don't need the medical establishment's approval. We do have several courses that are thought by medical doctors that also teach the same courses at medical schools. Where did you read that we were not taught anything by anyone that has a medical degree?
At least PA's are taught how to practice medicine by physicians.
We don't practice medicine so there is no need for medical doctors to teach us how to practice medicine.
You guys are not physicians, and you have no business delving into the medical issues of patients that do not strictly relate to neuromusculoskeletal medicine. 😴
You're not a physician either. You "assist" physicians. Your job is to deal with the minor stuff that pretty much any nurse or medical assistant could do. Isn't PA school like 2 years? 😀
Most of the world has already accepted chiropractors and the treatments they offer. You're right, its not you we need to convince or any other medical doctors, it's the public. I think we have already done that.
You will never be accepted as being competent medical providers because you are not taught by anyone with a medical doctorate.
Again, we don't need the medical establishment's approval. We do have several courses that are thought by medical doctors that also teach the same courses at medical schools. Where did you read that we were not taught anything by anyone that has a medical degree?
At least PA's are taught how to practice medicine by physicians.
We don't practice medicine so there is no need for medical doctors to teach us how to practice medicine.
You guys are not physicians, and you have no business delving into the medical issues of patients that do not strictly relate to neuromusculoskeletal medicine. 😴
You're not a physician either. You "assist" physicians. Your job is to deal with the minor stuff that pretty much any nurse or medical assistant could do. Isn't PA school like 2 years? 😀
Don't go there Backtalk, how long is chiro school? If you want to compare years of education, you are no more qualified to be a "physician" than a PT. Yet in the same or fewer number of years, you have claimed the title doctor with many of your colleagues not even obtaining a bachelor's degree. what is it 5-6 years from high school? 2-3 years of professional training? sounds familiar.BackTalk said:
Neither of us is qualified to be a physician.
If chiropractors put the effort they expend defending the profession into studying and simply going to medical school, they would become great physicians. When I hear chiropractors discuss/defend there trade, they never seem to do it any justice. They always end up sinking deeper into the hole. Why pretend your something your not? Just because you read a medical text, it doesn't mean youre prepared to treat or identify what it is you may have studied in the classroom or lab. It's really a simple lesson; let me put it metaphorically. (True story) My truck (1996 ford) was leaking oil from the valve cover gasket the end of last year. I figured, what the heck, I'll buy one of those books you see at the auto store and fix it myself. "Backyard" mechanics do it all the time. So I get the book and parts that I needed, read the section that I think I needed to read. After reading the book I felt confident that I could do the job. I tear the thing apart and wow, I was lost. Understand, I read the book and have a reading comprehension as good as the next guy, but I couldn't fix it. In fact, I wasn't even sure I was trying to fix the right thing. So I called this guy I know who is very nice but wasn't very bright. In fact he can't read. But he came over, looked at what I had done, started tearing all kinds of Sh*& apart. I was freaking nervous. Guess what, he had the thing fixed and running in about an hour and a half. He didn't read a book and surely didn't need one. He had experience working on trucks and learned it by someone who new a lot more than he did.
My point is almost elementary, but so valid when discussing chiropractors and there self-defined abilities. I know you guys think that nobody understands your education and experiences. Entertain the idea that physicians and PA's have a little more insight into what your abilities are than you would like to believe. They know the didactic portion that they have been through, and perhaps you can argue yours was just as comprehensive. They also know the clinical training in medicine they have been through, and they also know that chiropractic training offers nothing like it. - The guy that came to fix my truck looked at me and new that my hands have never been greasy before - and he was absolutely right.
My point is almost elementary, but so valid when discussing chiropractors and there self-defined abilities. I know you guys think that nobody understands your education and experiences. Entertain the idea that physicians and PA's have a little more insight into what your abilities are than you would like to believe. They know the didactic portion that they have been through, and perhaps you can argue yours was just as comprehensive. They also know the clinical training in medicine they have been through, and they also know that chiropractic training offers nothing like it. - The guy that came to fix my truck looked at me and new that my hands have never been greasy before - and he was absolutely right.
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DPTATC said:
Most people entering chiropractic school have a bachelor's degree like me. So that's 4 years' undergrad and 4 years Chiropractic College which is 8 years. Those that do not have an undergraduate degree have 2 years premed and then 4 years of chiropractic school, which is 6 years. There are PA programs that are BA/PA and 4 years total.
I'm not saying I'm qualified as a physician or rather a medical physician. I believe the argument was over doing physical examinations which chiropractors are more qualified to do than a DPT, and especially the t-DPT they earned online.
I disagree wholeheartedly. First of all, Most of the chiropractors in my town, and there are 5, do not have a bachelors degree. The average GPA of those who apply to DC school is 2.9 suggesting that they aren't excelling in that undergraduate program. (more C's than A's )BackTalk said:
Secondly, you need to define physical examination. the DPT whether standard and on-campus or the transitional earned online comprise the same coursework. The clinical time is not neccessarily increased depending on the program. The physical exam taught in PT school or in athletic training curricula are very thorough. So I dispute the claim that you do a better exam than I do.
Thirdly, when either you or I assess someone and find a systemic disorder, or at least one that doesn't fit in th NMS set of symptoms we should refer. My problem with many chiropractors is that they don't either because they were not talented enough to understand what you say that they were taught, or they are the bain of you profession, one who thinks that they can fix everything with an adjustment.
Thats it. I really give up trying to learn about chiropractic on this forum. There is absolutely no point in asking a question when the majority of what I get back is hostility and some very uneducated answers (from PAs mostly). Many of you say that chiropractors are trained well enough to diagnose many conditions that are beyond their scope of practice which I feel has some validity, but I stress some. Heres a little story: My father, a practicing chiropractor for 25 years, had a new patient come into his office last week and this patient was complaining about severe neck pain. My father, instead of just adjusting him which is what many of you PAs think all chiropractors do, took C-spine X-rays and told him there was nothing that he could do for him and that he should go to the ER. My Dad saw and lump attached to the C3-C5 vertebra that looked like some kind of tumor. My father knew what it was immediately, but Im sorry I dont recall the exact medical terminology. In essence, my father saved this mans life from NOT adjusting him and forcing him to go to the ER because what this man had was lethal. (Maybe some of you MDs can tell me what this man had). When asked, my father told me that he learned about these symptoms the man presented in Chiropractic College and from studying he recognized what was wrong. Im sure not every chiropractor could have done this, *nor could some MDs* but Im just proving the point that DCs are not as incompetent as many of you assume they are. I KNOW without a doubt that I will get many responses quoting that what Ive said is wrong and crap like that. There is NOTHING that someone can say to make you understand or try to understand what chiropractic is all about. If chiropractic is the 2nd leading healthcare service in the world then dont you think it has some serious effectiveness?? Millions of people would not go to and pay for something they didnt feel attributed to their wellness.
(On another not: I would like to thank backtalk and SKIBOY and whoever else has answered my questions about chiropractic. I really appreciate your time and great answers that I know are right for the most part. I look forward to getting into chiropractic even more because of your great tips and facts. I know it must get tiresome to continuously defend something you believe in. It must also be hard knowing that youve worked hard for 7-8 years to get where you are just to have it slandered by others who dont or who refuse to listen to reason in the matter and just belittle it. I sympathize with you!)
bye for now,
Jesse14
3rd year Kinesiology and Health Science major
(On another not: I would like to thank backtalk and SKIBOY and whoever else has answered my questions about chiropractic. I really appreciate your time and great answers that I know are right for the most part. I look forward to getting into chiropractic even more because of your great tips and facts. I know it must get tiresome to continuously defend something you believe in. It must also be hard knowing that youve worked hard for 7-8 years to get where you are just to have it slandered by others who dont or who refuse to listen to reason in the matter and just belittle it. I sympathize with you!)
bye for now,
Jesse14
3rd year Kinesiology and Health Science major
I disagree wholeheartedly. First of all, Most of the chiropractors in my town, and there are 5, do not have a bachelors degree.
Really? What did you do? Did you go door to door and ask them?
The average GPA of those who apply to DC school is 2.9 suggesting that they aren't excelling in that undergraduate program. (more C's than A's )
As we have discussed before, GPA isn't everything. Yes, I do agree that entrance requirements for chiropractic school are pretty weak.
Secondly, you need to define physical examination. the DPT whether standard and on-campus or the transitional earned online comprise the same coursework. The clinical time is not neccessarily increased depending on the program. The physical exam taught in PT school or in athletic training curricula are very thorough. So I dispute the claim that you do a better exam than I do.
Physical examination means a full body examination that includes breast, prostate and hernia examinations. We will omit pelvic since neither of us has practical experience (that is in a medical setting 😀). What do you do when you need an x-ray or MRI or CT or any other imaging modality? What diagnostic tests do you order? Which ones are you trained to interpret? Do you order any labs? Without these tests at your disposal, how are you able to do a better exam than me? If physical therapists are qualified to do physical examinations other than the typical neurological and orthopedic examinations, then why aren't you doing school physicals, or sports physicals, pre-employment physicals or DOT physicals? Why do insurance companies pay chiropractors for E/M codes but not physical therapists? Could it be its not within your scope of practice because your not trained in it? Why do insurance companies require a physician referral in order for insurance reimbursement?
Thirdly, when either you or I assess someone and find a systemic disorder, or at least one that doesn't fit in th NMS set of symptoms we should refer.
That's true and we do refer.
My problem with many chiropractors is that they don't either because they were not talented enough to understand what you say that they were taught, or they are the bain of you profession, one who thinks that they can fix everything with an adjustment.
Not all chiropractors are like that. Just like not all medical doctors think a pill or surgery is the answer for every ailment.
Really? What did you do? Did you go door to door and ask them?
The average GPA of those who apply to DC school is 2.9 suggesting that they aren't excelling in that undergraduate program. (more C's than A's )
As we have discussed before, GPA isn't everything. Yes, I do agree that entrance requirements for chiropractic school are pretty weak.
Secondly, you need to define physical examination. the DPT whether standard and on-campus or the transitional earned online comprise the same coursework. The clinical time is not neccessarily increased depending on the program. The physical exam taught in PT school or in athletic training curricula are very thorough. So I dispute the claim that you do a better exam than I do.
Physical examination means a full body examination that includes breast, prostate and hernia examinations. We will omit pelvic since neither of us has practical experience (that is in a medical setting 😀). What do you do when you need an x-ray or MRI or CT or any other imaging modality? What diagnostic tests do you order? Which ones are you trained to interpret? Do you order any labs? Without these tests at your disposal, how are you able to do a better exam than me? If physical therapists are qualified to do physical examinations other than the typical neurological and orthopedic examinations, then why aren't you doing school physicals, or sports physicals, pre-employment physicals or DOT physicals? Why do insurance companies pay chiropractors for E/M codes but not physical therapists? Could it be its not within your scope of practice because your not trained in it? Why do insurance companies require a physician referral in order for insurance reimbursement?
Thirdly, when either you or I assess someone and find a systemic disorder, or at least one that doesn't fit in th NMS set of symptoms we should refer.
That's true and we do refer.
My problem with many chiropractors is that they don't either because they were not talented enough to understand what you say that they were taught, or they are the bain of you profession, one who thinks that they can fix everything with an adjustment.
Not all chiropractors are like that. Just like not all medical doctors think a pill or surgery is the answer for every ailment.
jesse14 said:
Well Jesse, what can I say, it's just the way it is. You and I know the facts; we don't need others telling us what we are trained and not trained to do. I always find it fascinating how these people seem to think they know everything there is to know about chiropractors. Well welcome to chiropractic and if you decide to go all the way, you will have to get use to the prejudices that exist from the medical profession. Just look at this site. They won't even allow DC to go under allied professions on their board.
BackTalk said:
And what will you do if you find an abnormality in any of these areas? Not much. And I find it very interesting that you mention these four areas.
There are plenty of PA's, nurse practitioners, and nurse midwives doing pelvics every day. Why would a chiro ever do one? Oh that's right - childbirth! I almost forgot that earlier post.
Remember this acronym from ER - TUBE - Totally Unnecessary Breast Exam. And lest you think that only chiros do this, fear not - I know an orthopedic surgeon who thinks they're important prior to knee arthroscopies as well. So trust me, I'll think the same about you as I do about him.
jwk said:And what will you do if you find an abnormality in any of these areas? Not much. And I find it very interesting that you mention these four areas.
There are plenty of PA's, nurse practitioners, and nurse midwives doing pelvics every day. Why would a chiro ever do one? Oh that's right - childbirth! I almost forgot that earlier post.
Remember this acronym from ER - TUBE - Totally Unnecessary Breast Exam. And lest you think that only chiros do this, fear not - I know an orthopedic surgeon who thinks they're important prior to knee arthroscopies as well. So trust me, I'll think the same about you as I do about him.
And what will you do if you find an abnormality in any of these areas? Not much. And I find it very interesting that you mention these four areas.
Yeah thats right, I typically just give them a big fat bill and send them on their way.
There are plenty of PA's, nurse practitioners, and nurse midwives doing pelvics every day. Why would a chiro ever do one? Oh that's right - childbirth! I almost forgot that earlier post.
If you would have took the time to read my post you would know we dont do pelvics. Chiropractors in Oregon may do pelvics as they take additional training in minor surgery and chirldbirth.
Remember this acronym from ER - TUBE - Totally Unnecessary Breast Exam. And lest you think that only chiros do this, fear not - I know an orthopedic surgeon who thinks they're important prior to knee arthroscopies as well. So trust me, I'll think the same about you as I do about him.
We are taught breast exams but chiropractors seldom do them. If I suspect anything I send them to their OB/GYN. Whatever, you think we do breast exams to get our kicks? What a perv!
BackTalk said:
No, I don't go door to door, I actually have civil relationships with 4 of them.
I don't do labs, I don't order films although I often suggest particular views or imaging techniques to my colleagues who can.
I don't do pelvics, breast exams, prostate exams etc . . . because I can't treat anything that has to do with those body parts, and since I am in the traditional medical model, I can count on the MDs, DOs, FNPs, and PAs to do that for me since they can actually do something about it. Just because you say that you can do those things, doesn't mean you do or should. Besides, you said yourself that you refer to the OB/GYN anyway if you suspect something unusual. No different than what I do. You refer, but many don't, you have to recognize that. You are a very reasonable person and you must agree that you are defending what I see as a small percentage of you profession. When I cast aspersions, I do not cast them at you 😍
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This thread is devolving. Is there any reason I should not close it?
If your dad is a chiropractor, why do you resort to this board to find out about this profession?jesse14 said:
PS If you dont like counter arguments, why post on a message board?
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tkim6599 said:
Close it. These threads will always devolve into medical model vs. chiropractic. While BackTalk is a (usually) moderate sounding board, he is unlikely to drastically change anyone's opinion. Similarly those who come to this forum "expecting" a fair and balanced discussion of chiropractic seem astounded that they are not embraced (e.g., skiiboy, jesse, and publichealth). There are chiropractic forums elsewhere for them to get the information they seek, without the allopathic/medical influence. That said, I doubt we, as an medical community, are likely to sway them from their beliefs.
In short, this thread has now ended up where any and all chiropractic discussions in this forum end, with two sides deeply entrenched, yelling at their monitors in frustration.
-H
DPT, thanks for the kind words. It is true we have to learn breast exams and prostate exams and hernia exams in school. We have to do at least three on live patients before we can graduate 😱 . I dont do breast exams or prostate exams or pelvics. Hernia exams I dont enjoy doing but if someone is getting a pre-employment physical or DOT, I have to. Honestly, Im not interested in doing any of those things. If the patient presents with a probable enlarged prostate Im not going to give them a prostate exam even though I learned how to. Ive done three and thats it. Im going to send them to someone who knows what they are doing and has done hundreds of them and know what to look for. But as a chiropractor, its my legal responsibility to do it or make sure they follow-up with a doctor who will. Also, I do not do many of these exams anymore. I leave the school physicals and sports physicals to the MDs. Yes we learn much more in school than we really use and if you dont do it on a daily basis you lose it. My practice is geared toward manual medicine but every once in awhile I will have a parent wanting me to do one. I have on occasion had to send the kid to his MD when I found something wrong. You are right there isnt allot I can do for these non NMS complaints but I need to know whats going on to give the patient the proper referral. I am overly cautious but I think that is a good thing even if its a burden for the patient to have to see another doctor. I think most of them appreciate the fact that I know when to draw the line. I think that many times MDs feel threaten that we are allowed to do these exams but its not about taking over their turf. Its about knowing what to do when we find a problem that needs to be addressed by them. I would never treat a patient for something I have no business treating. Personally, I dont want the liability and I dont want to miss something that could put the patient in harm. All I ask of the MDs I refer to is that they check the patient out and refer them back so I can treat their back or neck complaints or other benign NMS problems. Listen, many times I have patients with NMS complaints and I still have no clue what it is. I get stumped too, even though this is my area of expertise. I rely on all sorts of specialists to help. In fact, this week I had a patient that presented with neck pain but also is having these wild spells of vertigo. I did a cranial nerve exam and checked her vitals heart etc. I dont have an answer for her as to why she is having this. I have discussed this with her and am sending her to a neurologist for a consult.
Im glad you have good working relationships with a few DCs. I wish I had someone like you I could rely on. I dont do much rehab and would like to have a good therapist like you to work with. I will handle the manipulations and you handle the rehab, its a win win situation. You are right there are many chiropractors out there that think they are more than they really are. In fact, some of them probably would just start whaling on this young girls neck without investing the vertigo first. I think these days chiropractors are being educated better than ever and most young guys like me will rely on specialists like I do. Again, we are not physicians and that is not what I was trying to imply by addressing the stethoscope issue. Jesse wanted to know about why we use them so I explained it. Then I started getting bombarded by people saying we basically have no business using them.
Im glad you have good working relationships with a few DCs. I wish I had someone like you I could rely on. I dont do much rehab and would like to have a good therapist like you to work with. I will handle the manipulations and you handle the rehab, its a win win situation. You are right there are many chiropractors out there that think they are more than they really are. In fact, some of them probably would just start whaling on this young girls neck without investing the vertigo first. I think these days chiropractors are being educated better than ever and most young guys like me will rely on specialists like I do. Again, we are not physicians and that is not what I was trying to imply by addressing the stethoscope issue. Jesse wanted to know about why we use them so I explained it. Then I started getting bombarded by people saying we basically have no business using them.
H, I may have pushed the envelope on this one. You know many times I speak first before thinking. It is true that there are other boards for us to go to but its nice to still chat with the medical profession and its good for us to know the reasons many here feel the way they do. It has changed me quite a bit. Before I came here I was against vaccinations, but since talking to you guys I have a totally different opinion now. I would never get that talking to other chiropractors. I think this whole chiro vs medical thing is a good thing for both of us. Yes, it usually boils down to the same old opinions but with each thread I think we all learn a little more or at least I do.
Let me make a singular point...Jesse's father did the correct thing, referral. There was no attempt to diagnose, no attempt to treat, simply recognition...fantastic job.
Once again, I feel whole heartedly that DC's are the masters of manual medicine and should stick with such a distinction. Doint too much dilutes and de-emphasizes their strengths and fosters the notion that they are not "real doctors". I would bet the most useful tool a DC has is their hands...why? because their training is extensive. Using a stethoscope is not a strength much like a MD cannot accurately palpate segmental motion (aint what they do).
Once again, I feel whole heartedly that DC's are the masters of manual medicine and should stick with such a distinction. Doint too much dilutes and de-emphasizes their strengths and fosters the notion that they are not "real doctors". I would bet the most useful tool a DC has is their hands...why? because their training is extensive. Using a stethoscope is not a strength much like a MD cannot accurately palpate segmental motion (aint what they do).
!dr_nick! said:
By father does not know and is not the be all and end al of chiropartic. It is always good to get different perspectives on the profession, don't you agree? And inorfer to have a counter argument i would have had to make an initial argument and i did so such thing. I simply asked a question (reason for this post).
I do not want to argue with anyone because i respect what every person in health care does and i just love absorbing all of your knowledge!
i hope i'm still welcome here!
If you don't speak with reasonable people who hold different views than you do, you will not grow personally or professionally. I enjoy these discussions. I learn that there are reasonable chiropractors who don't think that fixing a subluxation will help someone resolve their diabetes and that touch therapy will not fix their aura and make fibromyalgia go away. There are those that think that and they are the zealots that base their treatment on faith, not science.
Unfortunately, it is those people, just like in politics, who hold extreme views that get the most attention. It is my opinion that the chiropractic profession would flourish and gain more mainstream approval by both the public and the medical community it if could somehow clean those people up a bit and present a more reasonable public image. When you frame a debate with your opponent, or if you are trying to persuade someone, you must speak in words and language that they understand. I laugh when people post things like "fix the subluxation and let the innate universal intelligence take over". That is not my language so it sounds like Charlie Brown's teacher.
Unfortunately, it is those people, just like in politics, who hold extreme views that get the most attention. It is my opinion that the chiropractic profession would flourish and gain more mainstream approval by both the public and the medical community it if could somehow clean those people up a bit and present a more reasonable public image. When you frame a debate with your opponent, or if you are trying to persuade someone, you must speak in words and language that they understand. I laugh when people post things like "fix the subluxation and let the innate universal intelligence take over". That is not my language so it sounds like Charlie Brown's teacher.
