Chiropractic physicians in hospitals

FoughtFyr said:

Licensure in some states but very few.

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You really should look up the facts before you use words like "some" and "few" because the following States only require one year of internship for a medical license:

Alabama, Arizona, Arkansas,*Colorado, *Delaware, *Georgia, *Hawaii, *Idaho, *Indiana, Iowa, *Kansas, *Massachusetts, *Minnesota, *Mississippi, *Missouri, *Montana, *Nebraska, *New York, *North Carolina, *North Dakota, *Oregon, *South Carolina, *Tennessee, *Texas, *Vermont, *Virginia, *West Virginia, Wisconsin, *Wyoming.

The starred (*) states require more years from FMG's, though. Most require three years for FMG's; however, Hawaii, Indiana, Kansas, Massachusetts, Minnesota, and Wyoming only require two. Note that Oregon has an approved list of foreign shools and those graduates only need one year.

Louisiana has no requirements for US graduates other than Step I, II, and III; FMG’s need three years. DC has no requirements other than Step I,II, and III and graduation from a US or Canadian School.

The other states require two years from US graduates, except for Neveda with three.

That hardly seems like a "few" states to me. Mathematically it would be considered a "majority".

scpod said:

You really should look up the facts before you use words like "some" and "few" because the following States only require one year of internship for a medical license:

Alabama, Arizona, Arkansas,*Colorado, *Delaware, *Georgia, *Hawaii, *Idaho, *Indiana, Iowa, *Kansas, *Massachusetts, *Minnesota, *Mississippi, *Missouri, *Montana, *Nebraska, *New York, *North Carolina, *North Dakota, *Oregon, *South Carolina, *Tennessee, *Texas, *Vermont, *Virginia, *West Virginia, Wisconsin, *Wyoming.

The starred (*) states require more years from FMG's, though. Most require three years for FMG's; however, Hawaii, Indiana, Kansas, Massachusetts, Minnesota, and Wyoming only require two. Note that Oregon has an approved list of foreign shools and those graduates only need one year.

Louisiana has no requirements for US graduates other than Step I, II, and III; FMG’s need three years. DC has no requirements other than Step I,II, and III and graduation from a US or Canadian School.

The other states require two years from US graduates, except for Neveda with three.

That hardly seems like a "few" states to me. Mathematically it would be considered a "majority".

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Does anyone happen to know how easy it would be to get malpractice insurance and hospital privilages with only 1 year post-grad under your belt?

PublicHealth said:

Hey, I thought only chiropractors were supposed to cut corners!

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Ha, guess I earned that one. I have no intention of doing it, that question was more to attempt to show that it wasn't realistically possible to practice much medicine with only a transition year.

fun8stuff said:

i have a hard time understanding why they can do this when they have no training in pharmacology. what is oregon thinking?

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One semester pharmacology in chiro school. Not that that is enough to de-rx or rx. I guess it provides a basic understanding.
Mecca chiropractic? Was that a ha ha!! Never heard of it.

611 said:

One semester pharmacology in chiro school. Not that that is enough to de-rx or rx. I guess it provides a basic understanding.
Mecca chiropractic? Was that a ha ha!! Never heard of it.

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No, not a ha-ha. Here is what remains of the school: http://www.fnun.edu/ (with a history here: http://www.fnun.edu/history.html since I know some of you will claim there has never been a "Mecca College of Chiropractic". Don't get me wrong, I know this wasn't an accredited school, and I am certain there are / were other non-accrediated schools out there. My point is their graduates in chiropractic practice are probably as rare as a physician practicing with only a year of residency. Back in the day, sure, but now, not so much...). They used to offer a non-CCE approved BC, MC, and PhC. under the name "Mecca College of Chiropractic". In states without specific stipulation for DCs to have gone to a CCE school, these folks could practice. They also offered a "non-clinical" or "drugless"DO, but the laws regarding DOs were generally tougher to for licensure (and no DEA # would be forthcoming). I am not claiming there are a "majority" or even an appreciable minority of practicing chiropractors from Mecca. But neither are there an appreciable number of MD/DOs practicing without finishing residency.

- H

scpod said:

You really should look up the facts before you use words like "some" and "few" because the following States only require one year of internship for a medical license:

Alabama, Arizona, Arkansas,*Colorado, *Delaware, *Georgia, *Hawaii, *Idaho, *Indiana, Iowa, *Kansas, *Massachusetts, *Minnesota, *Mississippi, *Missouri, *Montana, *Nebraska, *New York, *North Carolina, *North Dakota, *Oregon, *South Carolina, *Tennessee, *Texas, *Vermont, *Virginia, *West Virginia, Wisconsin, *Wyoming.

The starred (*) states require more years from FMG's, though. Most require three years for FMG's; however, Hawaii, Indiana, Kansas, Massachusetts, Minnesota, and Wyoming only require two. Note that Oregon has an approved list of foreign shools and those graduates only need one year.

Louisiana has no requirements for US graduates other than Step I, II, and III; FMG’s need three years. DC has no requirements other than Step I,II, and III and graduation from a US or Canadian School.

The other states require two years from US graduates, except for Neveda with three.

That hardly seems like a "few" states to me. Mathematically it would be considered a "majority".

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Yep, scpod, you are correct (since I have been chastised for not admitting when I am wrong). By the "letter of the law", a majority of states allow practice after completing one year of residency. Others allow it after two, and none actually mandate the completion of residency - but you need to actually look at the statutes. As someone who holds a medical license in the State of Minnesota (one of those listed above), I can tell you from personal experience that 3 letters of recommendation from practicing physicians were required (mind you, you could only apply after you finished the first year of residency). On the recommendation form was a section "Do you see any reason the applicant might not complete their remaining medical eduction satisfactorily?" These letters were reviewed during the face to face interview required by the statue. If I had quit after the first year, while the rules might allow it, it was obvious that I would not have passed the interview. The reason for allowing licensure after the first year is more financial and practical for training than a statement the individual is ready to practice on their own. An attending physician (as opposed to a resident) has to re-complete a very large portion of the history and physical (according to CMS) if a resident doesn't hold a license. With one, the requirements are greatly reduced. This is a function of autonomy, not one of being ready to practice independently. The states know this, and use other criteria, such as Minnesota's interview, to prevent, in a practical sense, an individual from entering individual practice after only one year of post graduate training.

The second point you leave out in your discussion is that of hospital privileges. For moonlighting purposes, I have privileges at a number of facilities. On application for each I was asked if I ever "failed to complete" any portion of my training. I would fully agree, however, that you should never be cared for by a physician who does not maintain privileges at any hospital. It removes a significant level of QI/QA. And all of this says nothing of trying to get malpractice insurance without completing training.

Even if we ignore everything above, an MD or DO with one year of post-graduate training still has 1 2/3 years (2 1/2 "academic years") more training than a chiropractor - which was the argument that led us to this discussion. And the experiences that physician will have had in that "intern" year will extend far beyond those offered at any chiropractic college (in terms of patient acuity and volume). So the point remains the same, a third year chiropractic student is not equivalent to a fourth year medical student (for purposes of designing comparison studies) and MD/DOs by any measure, have, at the least, 1 1/2 times the training chiropractors (although most have much more).

In reality, most, in fact the overwhelming number of, physicians in practice have completed (or will complete) their residency training. But yes, you can practice without doing so. I fully admit that. It is just incredibly rare.

- H

PublicHealth said:

I don't think DCs would be offended by this title at all.

Physician, by definition, is someone who practices the healing arts. Optometrists, podiatrists, naturopaths, and other doctoral-level professions use the title physician. Yes, they are called optometric physicians, podiatric physicians, and naturopathic physicians. State law regulates the use of this title, however. Some states allow chiropractors to use the term "chiropractic physician," while other states do not.

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How about dental physicians (DMD/DDS)? Veterinary physicians (DVM)? Pharmaceutical physicians (PharmD)? Psychological physicians (PsyD/PhD)?Physical therapy physicians (DPT)? Audiological/audiometric physicians (AuD)? Soul physicians (MDiv/DMin)? Physician assistant physicians (PA)? Nursing physicians (NP)? Oh, wait, I know...LEGAL PHYSICIANS (JD)? Is there a line that needs to be drawn? Doctor as a term indicates the degree one has earned and the title that comes with that degree, not one's profession. However, physician is a different story. To use this term without being an MD, DO, or DPM is patently unethical and very misleading.

Actually, the use of the title physician, in MOST states, applies only to allopaths, osteopaths, podiatrists...and occasionally non-MD oral-maxillofacial surgeons. Surgeon can apply to MD, DO, DPM, and DDS (oral and OMFS). Given your generic definition, nurses, pharmacists, PTs, SLPs, psychologists, optometrists, etc., would be physicians.

Chiros appropriated the term physician, but legally and ethically, their use of this term is misleading and potentially dangerous.

I'm not going to attack chiros or ODs here, but I'll say this, if you're a chiro or opto, for liability purposes, you should avoid using the term physician and stick with chiropractor, DC, or Doctor of Chiropractic. Don't use terms like sports physician, physical medicine specialist, rehab physician, chiropractic physician, etc. To do so is to open the door to a plethora of litigation even if your state allows you to use that term. To hold yourself out as a physician places your standard of care at the same level as that of an MD or DO.

Mike MacKinnon said:

well said FF.

611 = Troll. no point in responding to him.

Jesse. You clearly know nothing about medicine yet seem to be making judgements about it which are baseless. DC's seldom participate in essential research which is peer reviewed and published in medical journals, this is easy to find out with a quick PubMed search. Secondly, there is no proof in existance that a DC's practice does anything more than a good PT or massage thearapist.

Remember, DO's started out with the idea that there was nothing more needed than manipulation. They profession has gone away from this based on the inability to prove it true. The medicine a DO practices and that of an MD are identicle (as is the education and post education) hence the reason DO's are considered equivilents to MD's. The education and post education of a DC is not compareable in ANY sense. They are an additional "alternative" therapy without signifigant evidence to prove efficacy.

If you believe otherwise, please show me the evidence to prove your assertions.

...... Oh, thats right, there is none.

thanks for commin out.

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Can someone tell me why a DC would have privis at ANY legitimate hospital? Why would a DC be allowed to practice in any ED/ER or IP setting? They have no business being in hospitals. If you want to practice medicine, get an MD/DO or become a PA and then work in a hospital. If you want to use unempirical quasi-scientific quakery, engage in unethical/unprofessional and often dangerous business practices, and spend the rest of your life kicking yourself for choosing chiro school over other professions, go and get your DC.

Case closed.

DCs are not qualified to practice in an inpatient or ED setting. DCs are NOT physicians. DCs are not primary care health providers. DCs are not trained to perform any legitimate medical services.

Hey, let's let veterinarians and astrologers practice in hospitals! Get real!

611 said:

What happens if a med. student graduates school after 4 years and he cannot get into a residency program of his/her choosing? Are there enough residency programs to go around?

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He'll match to something somewhere, usually FP or GP. Or...he can teach at a chiro school.

ProZackMI said:

Can someone tell me why a DC would have privis at ANY legitimate hospital? Why would a DC be allowed to practice in any ED/ER or IP setting? They have no business being in hospitals. If you want to practice medicine, get an MD/DO or become a PA and then work in a hospital. If you want to use unempirical quasi-scientific quakery, engage in unethical/unprofessional and often dangerous business practices, and spend the rest of your life kicking yourself for choosing chiro school over other professions, go and get your DC.

Case closed.

DCs are not qualified to practice in an inpatient or ED setting. DCs are NOT physicians. DCs are not primary care health providers. DCs are not trained to perform any legitimate medical services.

Hey, let's let veterinarians and astrologers practice in hospitals! Get real!

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i'd let a vet be my doctor/surgeon before a chiro. At least the vet would know what is wrong with out me even having to speak

nebrfan said:

Unfortunately, not so here in nebraska...they recently were allowed to use the title "Chiropractic Physicans" - they advertise quite a bit about how 'Chiropractic Physicians' are trained to treat common ailments w/out harmful drugs or surgery' and they even have a section on the Nebraska Chiropractic Physicians Association website entitled Will you be our Family Doctor? ... as I've said before, this is going to get someone hurt or killed.

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Here's what I noticed about that. Chiropractors like to perpetuate the false notion that there are three or four modalaties of medicine: (1) Allopathic (MD); (2) osteopathic (DO); (3) Chiropractic (DC); and (4) Naturopathic (ND). This is patently false information. There are only two true modalities of medicine: (1) Allopathic and (2) Osteopathic. The differences between MD and DO training is minimal today, so eventually, my guess is that there will be one conventional modality of medicine: a hybrid of allo/osteo.

You could say there might be a third form called alternative medicine, but that's debatable. Podiatric medicine is basically a branch of allopathic medicine, so I'm not going to list it as being separate. Nevertheless, the chiros really promote this misleading crap that they are another form of physician just like DOs. Here's the quasi-syllogistic reasoning they employ to convince themselves and others that they are primary care physicians:

1) Medical doctors are highly-trained full service, unlimited health care providers.

2) Osteopaths have a different training than MDs, but have now taken their place alongside MDs as being highly-trained, full service, unlimited health care providers. DOs moved from being PCPs and physicians focusing on musculoskeletal problems to multispecialized physicians (e.g., psychiatry, pathology, GI, cardio, etc.).

3) People confuse DO and DC as they both emphasize manipulation and embrace alternative treatments.

4) Since DOs have been accepted as MD equivalents and have increased their status and are considered equals to MDs, DCs can do this by convincing the public that they are like DOs and can treat a full range of medical problems, not just LBP or generalized myalgias/arthralgias.

It's a very weak inference, but it's one that DCs are hoping the uninformed public will buy. It's one they are also diligently trying to convince state legislators so that they can affect the laws that govern the practice of medicine.

The truth is, an MD and DO are trained as physicians. Like froughtfyr and others have pointed out, medical school is 4 years of didactic and clinical work that enables the student to diagnose and treat conditions manifested in all body systems. I'm a psychiatrist, but I did a joint IM/Psych residency. While in med school, and as a resident, I did rotations in neuro, cardio, ER, OB-GYN, surgery, etc. I read labs, interpreted MRIs, CTs, EEGs. I ordered labs. I saw patients in the ER. I participated in a variety of surgical procedures. THEN I specialized and received intense training in one area of medicine. However, I actually had hands-on training in a variety of medical specialities. My brief training in these areas, while in med school and during residency, still don't qualify me to practice in these areas.

I have a very good understanding of what a detached retina entails, but would I treat one? HELL NO! I know the signs and symptoms of endrometriosis and uterine fibroids, but would I dare perform a D&C or hysterectomy? Not if I want to keep my license and not end up on the wrong side of a negligence/med-mal suit.

An ethical and competent health care provider is able to know his place in the health care system. He knows his training and experience and knows not to overstep his bounds. An ethical and competent practitioner wouldn't even dream of doing something that might jeopardize the health and well-being of his patient. A good practitioner refers to other professionals who can best treat the patient. Many chiros claim that they can treat a myriad of maladies and disorders since they are primary care doctors. A DC degree qualifies one to perform chiropractic adjustments, not perform pelvic exams. A DC degree does not teach one to conduct a mental status examination, read bloodwork, interpret an EEG or EKG, interpret an EMG/NCS, or understand multisystem pathology.

Yeah, they teach you how to take BPs in chiro school. So? A CMA with no degree can do that. So? Do you know how to interpret the numbers? Do you know what systolic and diastolic mean? Do you know what hypertensive end organ damage is? Do you know the difference between rales, rhonchi, and wheezing? Do you know how to differentiate between the various grades of heart murmurs? Do DCs know what Babinksi, Tinel's, and Phalen's signs are? Can they tell by reading a lab that their patient is in ESRF secondary to diabetic nephropathy? Does a DC know what an HCT, HGB, ESR, serum bilirubin, SGPT, SGOT, and BUN is? SMAC? CBC? Most DCs probably think anasarca is a continent covered in ice and snow and ascites is something that happens when one's ass freezes over.

A DC might be able to perform some basic NMS adjustments and alleviate some pain, but are they really comprehensive primary care doctors? I really find the claim that they are physicians on par with MDs or DOs to be misleading and offensive.

doclm said:

I wouldn't say that Podiatrists are not considered physicians. They go through the same 4yr medical school model as MD/DO's. Many Podiatry schools have DPM students taking the same classes as the MD/DO students. My starting class schedule this fall at RFU is: Gross Anatomy with MD students, Biochemistry with MD students, also Neuroscience, Micro/Immunology, Histology....pretty much very similar curriculm for the first two years. Then DPM students have to take their first set of medical boards similar to MD/DO's. The third and fourth year consists of clinical rotations and externships: Derm, Ortho, Peds, Radiology, Anes, ect.. Then after the 4th yr. the DPM will take their second set of medical boards. Next they will do a 2 or 3 yr residency at a hospital in Podiatric Medicine and Surgery. These residencies compose of Anesthesiology (acutally intubating pt's), Orthopaedics (assisting hip, knee, and of couse foot surgery, and covering call for Orthos at some places). Some Podiatry rotations include Pathology, Radiology, Infectious Disease, Dermatology, General / Vascular Surgery, Internal Medicine, ER, Anesthesia, and Orthopedic Surgery. Yeah, and don't forget being able to prescribe medications.

After all of this: Do you really think that a DPM is not considered a physician?

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DPM school is NOT the same as medical school, but...DPMs are considered physicians in most states because they do perform minor and major surgery on the feet and ankles and they do have fairly unlimited RxPs. Podiatry has improved its professionalism over the years and most in the medical community appreciate and respect their training and competence. Unlike ODs and DCs, DPMs, in my experience, don't try to bite off more than they can chew. They usually refer to an orthopod, neurologist, or internist the things they don't feel comfortable treating, or when the treatment involves above the ankle care.

DPMs are also granted full privis at most good (meaning not VA) hospitals and clinics. DPMs also receive comprehensive training in pharm, path, surg, dx, and tx...unlike the DCs and ODs.

ProZackMI said:

DPM school is NOT the same as medical school, but...DPMs are considered physicians in most states because they do perform minor and major surgery on the feet and ankles and they do have fairly unlimited RxPs. Podiatry has improved its professionalism over the years and most in the medical community appreciate and respect their training and competence. Unlike ODs and DCs, DPMs, in my experience, don't try to bite off more than they can chew. They usually refer to an orthopod, neurologist, or internist the things they don't feel comfortable treating, or when the treatment involves above the ankle care.

DPMs are also granted full privis at most good (meaning not VA) hospitals and clinics. DPMs also receive comprehensive training in pharm, path, surg, dx, and tx...unlike the DCs and ODs.

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C'mon now, can't you leave the ODs out of it for once?
You write good, well argued posts, no denying that. But seriously, don't go comparing ODs to chiros.... one, it just doesn't work; two, this thread has nothing to do with ODs.

An OD is definately not even remotely comparable to an ophthalmologist, since the latter receives considerably more training (about twice as much, just in terms of length of program), and is more knowledgable and competent in terms of diagnosing and treating eye disorders. However, to be fair, to compare an OD to a chiropractor is like comparing gold to turd. OD's don't claim they can cure anything from glaucoma, to idopathic structural scoliosis, to high blood pressure, to otitis media, to cancer, to AIDS etc. etc., whereas chiropractors, at least the vast majority, claim they can.

psisci said:

I agree with prozackmi, only MD/DO and maybe DPM or DDS folks should have the titale physician. In the psychologist RxP move I saw some start to move into calling RxP trained psychologists, psychologist physicians, and it is stupid! I am happy with the medical psychologist term. I am well trained to do what I do, but I would NEVER play myself off as a physician, and nor should DC, OD folks.

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Agreed

seanjohn said:

An OD is definately not even remotely comparable to an ophthalmologist, since the latter receives considerably more training (about twice as much, just in terms of length of program), and is more knowledgable and competent in terms of diagnosing and treating eye disorders. However, to be fair, to compare an OD to a chiropractor is like comparing gold to turd. OD's don't claim they can cure anything from glaucoma, to idopathic structural scoliosis, to high blood pressure, to otitis media, to cancer, to AIDS etc. etc., whereas chiropractors, at least the vast majority, claim they can.

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Meh...okay, okay! 🙂

nebrfan said:

It's amazing (scarey?) that in 10 'trimesters' they think they can teach someone not only how to practice chiropractic, but also how to (safely) practice primary care medicine - when MD/DOs devote at least 7 YEARS.....buying into this is going to get someone hurt or killed.

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No whats scary is that there are NP and PT's that learn spinal manipulation therapy in a weekend course and then try cervical adjustments on patients...DCs at least take 4 years to learn the practice
as for your "7" years of school basic MD is 4 years and your right then comes the residency, but theres no surgery performed by chiro, its all non-invasive. Yes the 1 in 3,000,000 chance of getting a VBI exists from cervical adjustments but people die from neglegent MDs as well

quack2be said:

No whats scary is that there are NP and PT's that learn spinal manipulation therapy in a weekend course and then try cervical adjustments on patients...DCs at least take 4 years to learn the practice
as for your "7" years of school basic MD is 4 years and your right then comes the residency, but theres no surgery performed by chiro, its all non-invasive. Yes the 1 in 3,000,000 chance of getting a VBI exists from cervical adjustments but people die from neglegent MDs as well

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Just curious, being the experienced chiropractic student that you are, what are the limits in which a chiropractor should practice?

lawguil said:

Just curious, being the experienced chiropractic student that you are, what are the limits in which a chiropractor should practice?

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Within the scope of practice of the state inwhich the Chiropractor is practicing.

611 said:

Within the scope of practice of the state inwhich the Chiropractor is practicing.

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Some chiropractors may recognize the limitations of what they can offer despite what a practice act allows.

first of all, i am not trying to bash any DCs out there.

i personally think a DC should not belong in a hospital enviornment. the only place close to a hospital a DC should be working at is maybe a rehab center? almost every patient at the hospital requires medical attention, and the DC is not trained for that support.

to become a DC you really have to love what your doing. there are going to be alot of people out there that are going to talk alot of garbage about you, about your career and so on. i was thinking about leaving my current school (dumb mistake, a UC school) and attending a chiro college to obtain my BS in human bio and DC degress jointly. after reading many posts and talking to many MDs and DCs i decided not to pursue it. when a DC tells you not to pursue the chiro degree, you know there is something up. now granted, there maybe alot of DC that tell you not go into chiro so they can save there own a**. im just not a 100% supporter of chiro, hence im not going into it.

just my thoughts

victor14 said:

first of all, i am not trying to bash any DCs out there.

i personally think a DC should not belong in a hospital enviornment. the only place close to a hospital a DC should be working at is maybe a rehab center? almost every patient at the hospital requires medical attention, and the DC is not trained for that support.

to become a DC you really have to love what your doing. there are going to be alot of people out there that are going to talk alot of garbage about you, about your career and so on. i was thinking about leaving my current school (dumb mistake, a UC school) and attending a chiro college to obtain my BS in human bio and DC degress jointly. after reading many posts and talking to many MDs and DCs i decided not to pursue it. when a DC tells you not to pursue the chiro degree, you know there is something up. now granted, there maybe alot of DC that tell you not go into chiro so they can save there own a**. im just not a 100% supporter of chiro, hence im not going into it.

just my thoughts

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No matter what you do in life you hopefully need to love it. You will be doing it everyday for the rest of your life. If people bash you, it won't bother you because you will be happy and believe in whatever it is you are doing. If people did not go into a profession because they are bashed we would not have any lawyers.

611 said:

No matter what you do in life you hopefully need to love it. You will be doing it everyday for the rest of your life. If people bash you, it won't bother you because you will be happy and believe in whatever it is you are doing. If people did not go into a profession because they are bashed we would not have any lawyers.

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if our government laws were based on the lifeforce of the universe, then being a lawyer would be equivalent to being a chiro. Until there is evidence that chiropractic is effective and that it is based on science, i dont think i will support it. However, I will not bash it in front of my patients and I will give them unbiased info if they ask me.

lawguil said:

Just curious, being the experienced chiropractic student that you are, what are the limits in which a chiropractor should practice?

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mechanical back pain will obviously be the brunt of the patients that most chiros will see (and should see in my opinion). Some treat sport injuries, some are more of a rehab venture.

There has been many comments about chiro's shouldn't be primary care providers, but whats wrong with a DC giving a patient advice on how to eat properfly or how to start an aerobic exercise program to ensure a longer lift with less dysfunction? To me thats a pretty basic route on how a DC can be a primary care provider...I'm not talking about immunizations or bracing or anything else thats outside the scope of practice.

I mean there are a lot of "claims" chiro do do in practice, everything from curing GI tract problems, OA, AVN, migraines and what not, a majority of this is quackery and it pisses me off when DC say that the ligaments in my arm became lax due to a subluxation at C2 and not because i feel on outstreatched hands (FOOSH) during a hockey game. Might as well back it up right now become a used car salesmen (not that there anything wrong with being that) cuz then we'll get a bunch of car salesmen in this forum and all hell will break loose

P.S.
i really dont mind coming to this forum and posting messages not becuase i want to pick a fight with all of you i'd rather have informed new MD's in the future that understand that the new DC's that are coming out there are not subluxation believers well at least not here in canada

quack2be said:

i'd rather have informed new MD's in the future that understand that the new DC's that are coming out there are not subluxation believers well at least not here in canada

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Maybe you could tell that to your homies down here in the States....

CHIROPRACTIC PRINCIPLE
Chiropractic is based on the premise that the relationship between structure and function in the human body is a significant health factor and that such relationships between the spinal column and the nervous system are the most significant, since the normal transmission and expression of nerve energy are essential to the restoration and maintenance of health. (ACA Master Plan, ratified by the House of Delegates, June 1964, amended, June 1975).
Resolved, that the House of Delegates reaffirms the core principle of the subluxation. The ACA will strive to reiterate this principle and further state that the core treatment of chiropractic is manual manipulation/adjustment of the articulations, both spinal and extra-spinal, to reduce subluxations, when called upon in relation to Federal legislative efforts, in addition to full scope of practice as allowed by state law. References to subluxation and chiropractic adjustments/manipulation should be made in ACA releases, whenever possible. (Ratified by the House of Delegates, September 2000).

American Chiropractic Association Position Statement

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quack2be said:

mechanical back pain will obviously be the brunt of the patients that most chiros will see (and should see in my opinion). Some treat sport injuries, some are more of a rehab venture.

There has been many comments about chiro's shouldn't be primary care providers, but whats wrong with a DC giving a patient advice on how to eat properfly or how to start an aerobic exercise program to ensure a longer lift with less dysfunction? To me thats a pretty basic route on how a DC can be a primary care provider...I'm not talking about immunizations or bracing or anything else thats outside the scope of practice.

I mean there are a lot of "claims" chiro do do in practice, everything from curing GI tract problems, OA, AVN, migraines and what not, a majority of this is quackery and it pisses me off when DC say that the ligaments in my arm became lax due to a subluxation at C2 and not because i feel on outstreatched hands (FOOSH) during a hockey game. Might as well back it up right now become a used car salesmen (not that there anything wrong with being that) cuz then we'll get a bunch of car salesmen in this forum and all hell will break loose

P.S.
i really dont mind coming to this forum and posting messages not becuase i want to pick a fight with all of you i'd rather have informed new MD's in the future that understand that the new DC's that are coming out there are not subluxation believers well at least not here in canada

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if you do not believe in subluxation, then how do you explain what you do? how do adjustments help people? it's obvious that the theory of subluxation is about as real as the toothfairy... so what's the latest theory now?

fun8stuff said:

if you do not believe in subluxation, then how do you explain what you do? how do adjustments help people? it's obvious that the theory of subluxation is about as real as the toothfairy... so what's the latest theory now?

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subluxation as a word has it's meaning in that a joint is not totally in the anatomically "normal" place. Now when DC talk to their patients they start dumbing things down to "nerve impingement" and blocked flow of nerve conduction...bah makes me cringe when i even type that explanation. Anyways, the accepted belief in the profession is mechanical dysfuntion or a fixated joint. Basically something that isn't moving right and this can cause pain becuase the menisci within the zygopophyseal joint are highly innervated. ALso there's the premise that a stiff joint one with a decreased ROM can be increased with SMT (spinal manipulation therapy) furthermore, the short term effects of a cavitation (what the cracking noise is defined as)are the release of endorphines into the surounding areas for 20-30 min (thus temporary relief, this might be why some over worked olympic athletes get an adjustment before there events, but thats a new discussion).

So there you have it i dont need the word subluxation at all, in fact i plan on never using it in practice...

I think its funny how the majority of you make reference to the original chiro belief of innate intelligence and subluxation blocking this intelligence (circa 1895) now...their is obviouly a religious overtone to this, however is this so bad? Hold on there dont start typing your replies yet...read on...

The time frame has to be accounted for, now i'm no american so my history will be off, but years before wasnt there a nation built on the slogan: "I God we trust"? And then there Geroge W...well i'll stay away from that...

My point is this, if all those damn stuborn chiro's could leave the old beliefs behind and move into the future the profession would be better off. And do i ever hope it happens soon!!! SUbluxation will probably be around for a long time (unfortunately) but innate intelligence isnt something that is taught as a belief to go by.

Heres a history lesson for you. DD Palmar and his son BJ, yes he prefered to be called BJ, fought long and hard for chiro's rights. The problem was with BJ everytime a chiro got arrested for practicing medicine without a liscence BJ would come in and said that chiropractic was "philosophically not medicine" this in my opinion was the biggest mistake ever made in the profession. Osteopathy was founded in the similar time period to chiropractic and some say DD stole the idea from Still but heres the kicker...if BJ would have kept his mouth shut would chiropractic have been assimilated into allopathic medicine just like osteopathy? would our colleges turn into 7 year programs allowing us to do all that which an MD or DO can? Honnestly its been 100 years of trying to get rid of chiropractic worldwide...if you really want us to stop cracking backs assimilate us into the system and SMT will go away just like it did in osteopathy...

quack2be said:

I think its funny how the majority of you make reference to the original chiro belief of innate intelligence and subluxation blocking this intelligence (circa 1895) now...their is obviouly a religious overtone to this, however is this so bad? Hold on there dont start typing your replies yet...read on...

The time frame has to be accounted for, now i'm no american so my history will be off, but years before wasnt there a nation built on the slogan: "I God we trust"? And then there Geroge W...well i'll stay away from that...

My point is this, if all those damn stuborn chiro's could leave the old beliefs behind and move into the future the profession would be better off. And do i ever hope it happens soon!!! SUbluxation will probably be around for a long time (unfortunately) but innate intelligence isnt something that is taught as a belief to go by.

Heres a history lesson for you. DD Palmar and his son BJ, yes he prefered to be called BJ, fought long and hard for chiro's rights. The problem was with BJ everytime a chiro got arrested for practicing medicine without a liscence BJ would come in and said that chiropractic was "philosophically not medicine" this in my opinion was the biggest mistake ever made in the profession. Osteopathy was founded in the similar time period to chiropractic and some say DD stole the idea from Still but heres the kicker...if BJ would have kept his mouth shut would chiropractic have been assimilated into allopathic medicine just like osteopathy? would our colleges turn into 7 year programs allowing us to do all that which an MD or DO can? Honnestly its been 100 years of trying to get rid of chiropractic worldwide...if you really want us to stop cracking backs assimilate us into the system and SMT will go away just like it did in osteopathy...

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Notice folks, his fingers never left the keys. Yes, it is the miracle child - the chiropractor! Slicker than a lawyer when it comes to not directly answering the question and twice as dangerous because he convinces his patients he is actually trained to care for them (everyone knows lawyers don't care for anyone!).

So, let's see, subluxation is a wrong and outdated theory (according to you - according to the CCE it is still to be taught at all US chiropractic colleges). But you, as a chiropractic student, are learning lots of neat stuff like cranial nerves so we should just assimilate you into medicine. It doesn't work that way. You are NOT a medical doctor and without going to medical school you won't be. What possible advantage would medicine gain by assimilating chiropractors? The main theory is bunk, soundly disproven many times over. SMT as a modality might have limited utility, but PTs can provide it. What does medicine possibly gain? A bunch of schools with questionable histories and few standards? No thanks. I'd rather just wait until the mountain of evidence stinks so high that no one pays for chiropractic anymore, then it will go away on its own.

BTW - you left out an important piece in your history lesson. Back in the early 1900s many persons of influence were Freemasons, as were both DD and BJ. Elbert Hubbard, a prominent freemason and a friend of BJ’s, was the person who persuaded John D. Rockefeller’s personal physician, to get Rockefeller to use chiropractic care. Later in 1963, Nelson Rockefeller would be the important person to get chiropractic accepted as legal in NY, and then appointed chiropractor Albert Cera to his Medical Advisory Committee. It has never been (at its founding or today) that chiropractic is clinically effective. It has always been that chiropractic is simply amazing at selling itself, working every connection, every angle. Even the latest study out of UCLA found that chiropractic was only "minimally clinically effective" but that most chiropractic patients were more likely to percieve improvement. (from: http://www.ncbi.nlm.nih.gov/entrez/...uids=16540862&query_hl=1&itool=pubmed_docsum). Charlatans, snake oil salesmen, and chiropractors all work the same - create enough hype and your "patients" will believe it. And if they get really sick, blame it on the real doctor they eventually go to - it must be their fault 'cuz our techniques always work on the good christian people of this her' county. You are a good christain man now ain't ya? I kno you are so it muzt be that thar MDs fault - did ya know they perform abortions? A chiropractor would never do that...

And as for the "but we are really smart people and already well educated" argument, I hate to tell you this but art majors who emphasize medical illustration have more anatomy training than both of us combined, but I'm not for issuing them prescription pads.

What hatered you present in your post. I can't say i really expected that type of responce. First, i thought some of you might be happy to see a future chiro to stop believing in subluxations and to be clearly an advicator of evidence based practice. But instead you make personal bashes at me for what? Because i wont spend as much time in school as you? will i be doing half the things that you will? NO. and please show me your literate becuase i have made several posts and not once did i call myseld a medical doctor. You claim i bring trickery to the table and confuse the patient with scare tactics yet i take a swipe at all the DC that talk about "nerve inpingement".
Not that its any of your business but no i'm not a christian and your condensending tone proves to me your bedside manners to your patients will truely suck...what if i become gravely ill one day and there you'll be at my bed side, doing what? laughing? smirking? becuase i'll be a chiro and you'll think i'm some quack? If i'm sick, if i have a pathological illness i'm going to see my doctor, i wont just crack my back or get someone to do it for me.

But i have to admit your attitude and overtone makes me upset (to which you'll probably laugh at and say "aww did i hurt you? you gonna cry to your chiro god's") And all it produces is a hatered towards the persona that some doctors have towards all the people out there that arent...dr's.

quack2be said:

What hatered you present in your post. I can't say i really expected that type of responce. First, i thought some of you might be happy to see a future chiro to stop believing in subluxations and to be clearly an advicator of evidence based practice. But instead you make personal bashes at me for what? Because i wont spend as much time in school as you? will i be doing half the things that you will? NO. and please show me your literate becuase i have made several posts and not once did i call myseld a medical doctor. You claim i bring trickery to the table and confuse the patient with scare tactics yet i take a swipe at all the DC that talk about "nerve inpingement".
Not that its any of your business but no i'm not a christian and your condensending tone proves to me your bedside manners to your patients will truely suck...what if i become gravely ill one day and there you'll be at my bed side, doing what? laughing? smirking? becuase i'll be a chiro and you'll think i'm some quack? If i'm sick, if i have a pathological illness i'm going to see my doctor, i wont just crack my back or get someone to do it for me.

But i have to admit your attitude and overtone makes me upset (to which you'll probably laugh at and say "aww did i hurt you? you gonna cry to your chiro god's") And all it produces is a hatered towards the persona that some doctors have towards all the people out there that arent...dr's.

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I wasn't referring to you as a christian or not, I was poking fun at the "carnival barker" attitude that most chiropractors I have come into contact with (at shopping malls, county fairs, and even a local municipal fireworks show) display. They hooked people up to machines to decipher their "magnetic poles", gave out "free" back rubs, and handed out certificates for free x-rays, all the while spewing forth lines that would make PT Barnum proud. And when (twice) I heard people seem to complain that a chiropractor had made a family member "worse", the patient or their eventual treating physician were blamed. So sorry if I have very little respect for the "profession". But I do sincerely apologize if you thought I was speaking about you personally (as opposed to the huxsterism you are learning).

One thing that you steadfastly refuse to answer (as have many others on this forum) is, if Palmer was wrong, and subluxations don't exist, then what is chiropractic? I will happily acknowledge that DCs spend between 3 and 4 years in school at the graduate level. But what are they learning and how does that learning (if the central premise of chiropractic is wrong) instill them with the right to lay hands on patients? (And I'm not talking about the legalities but rather the overall question of evidence base, oversight, and competence). There are people who spend comparable time learning about the human body, MSs in physiology for one example, but they don't pretend to be qualified to treat patients. How is it, in the absence of the central idea of chiropractic, that you are going to be qualified to do anything?

And if I sound heavy handed, I apologize, but as a third year medical student, just now seeing the light at the end of the tunnel of a very long year of 80+ hour weeks on the wards I find it personally insulting that anyone spew forth the idea that chiropractic education and MD/DO education are even close. If I were to be going into PM&R (the closest MD/DO to a chiropractor in terms of patient population) I would have another FIVE YEARS left in training (for a total of 8). Yet, you can do all of your training in 3 1/3. And I would see literally thousands of patients with real illnesses, have to deal with all of their issues, and learn the consequences of their illnesses, including death, first hand.

So spare me the f**king lecture on my bedside manner and come back to me after you've broken the news of death to a couple of families. You have no idea what relating to patients truly entails, other than your business and marketing courses.

Its about time...i was looking for an educated responce and it only took 48 hours. Yes i completely agree with you there are certain things that arent suppose to be going on in the profession yet some DC think they have that right. I see DC in malls and at carnivals as well and definetely its a market ploy. I honnestly wish there was some amazing research that has been done to prove the legitemacy of chiropractic. BUt as of yet there is little that screams of 100% unquestionable evidence.

As for the thousands of patients you see before actual practice, i only wish i could see that many i will only see a fraction of that in an out-patient clinic. There currently is a study being done with a chiro in a canadian hospital the findings after 6 months show a decrease in wait time for PT appoitments and a grant has been given to continue the research.

Basically all i'm saying is we all need to see evidence for chiropractic to lose its CAM title. But we all know that it will take time and RCTs are expensive and chiropractic isn't exactly the most widely funded profession. I mean who benefits from chiro research other then chiros and the public (if the research is positive towards them) MD wont help becuase we take patients away, pharmaceutic companies wont because we are regulated under the drugless practictioners act. Government? that doesnt even require an explanation.

In closing you have nothing to worry about chiros wont make it a regular practice in hospitals and we'll never take away patients from you. however just to comment about your remark about "come back to me once you tell a few families about a terminal illness" sorry not an exact qoute
A friend of my family was doing some plumming about a year ago, woke up with back pain, went to see his MD assumed it was a muscle strain and shruggled it off. months went by with no improvement MD changes the Ddx to chronic back pain. He then goes to a chiro, chiro diagnosis it as mechanical back pain. No improvement with SMT chiro has a the decency to order an x-ray, a tumor was found on the spine, he's been given less then a year to live. My point is everyone makes mistakes both the chiro and the MD had it wrong, but dont tell me that i'll never have any terminal patients. Not that i'm gonna try and cure them but maybe i'll alleviate some of there pain (even if it is just a placebo effect)

quack2be said:

I honnestly wish there was some amazing research that has been done to prove the legitemacy of chiropractic. BUt as of yet there is little that screams of 100% unquestionable evidence.

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Yet you continue to treat patients. The risks, while small, are well documented:

http://www.jcca-online.org/client/cca/JCCA.nsf/objects/V49-1-46/$file/jcca-v49-1-046.pdf

http://www.ncbi.nlm.nih.gov/entrez/...d&dopt=Abstract&list_uids=10768681&query_hl=8

http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=12743225

http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=12692699

http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=15513007

And from JMPT: http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=12466778

http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=14586598

http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=14589464

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7884327&dopt=Abstract

http://www.cmaj.ca/cgi/content/full/166/12/1531

http://www.cmaj.ca/cgi/content/full/166/12/1544

http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=11340209

quack2be said:

As for the thousands of patients you see before actual practice, i only wish i could see that many i will only see a fraction of that in an out-patient clinic. There currently is a study being done with a chiro in a canadian hospital the findings after 6 months show a decrease in wait time for PT appoitments and a grant has been given to continue the research.

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Yet once again without adequate training you will be out there treating patients...

quack2be said:

Basically all i'm saying is we all need to see evidence for chiropractic to lose its CAM title. But we all know that it will take time and RCTs are expensive and chiropractic isn't exactly the most widely funded profession. I mean who benefits from chiro research other then chiros and the public (if the research is positive towards them) MD wont help becuase we take patients away, pharmaceutic companies wont because we are regulated under the drugless practictioners act. Government? that doesnt even require an explanation.

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There has been plenty of research. Chiropractors just don't like the findings. There is a National Institutes of Health Center devoted solely to alternative medicine. Even they can not produce a study that demonstrates chiropractic is any better than medicine in any measure except patient satisfaction.

quack2be said:

In closing you have nothing to worry about chiros wont make it a regular practice in hospitals and we'll never take away patients from you.

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I worry more about you hurting patients.

quack2be said:

however just to comment about your remark about "come back to me once you tell a few families about a terminal illness" sorry not an exact qoute
A friend of my family was doing some plumming about a year ago, woke up with back pain, went to see his MD assumed it was a muscle strain and shruggled it off. months went by with no improvement MD changes the Ddx to chronic back pain. He then goes to a chiro, chiro diagnosis it as mechanical back pain. No improvement with SMT chiro has a the decency to order an x-ray, a tumor was found on the spine, he's been given less then a year to live. My point is everyone makes mistakes both the chiro and the MD had it wrong, but dont tell me that i'll never have any terminal patients. Not that i'm gonna try and cure them but maybe i'll alleviate some of there pain (even if it is just a placebo effect)

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You will never be the one to face a family and have to explain to them that their loved one is gone. You will never have to discuss cessation of heroic efforts. You will never deliver the news of a terminal illness. Every MD/DO will have those experiences, you won't. So come off the lecturing me about bedside manner. You have no idea what it is to discuss things when the stakes are really high. I'm not saying you won't have terminally ill patients, but please acknowledge that you will never be responsible for their care at the time of death, and you will never have to "break the news". And, you will never fully understand the risks you take with your patients because you will never watch (as a healthcare provider) the natural course of a stroke nor be responsible to explain the implications to a patient and their family. Must be nice... 👎

BTW - on a side note, I think I'm getting the hang of this HTML thing. Let's see how this post looks...

Haven't you all figured out weeze come from the cauldren of Hell itself and weeze devil worshipers. 🙄

Remember, weeze sat by all youze other Doc's out dere in pre-meds classes butz didn't learn a ding cuz we read the bookz backerds whilez you smarty pantz redz dem 4werdz. Datz y weeze do stoopid. 🙁

Denz weunz goez 2 skool for tree ur 4 ears and cutz up sum humunz but can't find uz a subwayluxation so now weez out din publick (love you Ron White) lukin 4 sum. 😀

Me thinks ifin I jest flip dem books upsid dowun den dey wllz luks gest likes yalls books and then maybe an intelligent conversation can be had once and for all about the STUPID SUBJECT. 😡

This is ridiculous. Why, oh dear God why, do MD/DO's get on here and want EVERYTHING a DC does or learns classified as unsatisfactory, not worthy of ANY credit for anything. And just as ridiculous why do D.C.'s still argue "we are just as smart as you guy's?". This point has been drilled in the ground a thousand times and nobody has struck pay dirt in intelligence yet.

It's just a friggin degree. No it's not medical school and it never will be but it is a professional school with accreditation and merit. No chiropractors should not be called physicians b/c it confuses the publick (yes, I know the correct way to spell it...it's a joke). Why? Because we don't have residency and don't have enough experience with differential diagnosis, plain and simple. Yes, there MAY be use for a D.C. on staff at a hospital with PT's under supervision by an M.D. For what use? B/C nobody has more experience doing spinal manipulation (when appropriate) than a chiropractor, plain and simple.

Do you need 8 years of college to learn spinal manipulation? NO. 😱 You need 8 years of college to know when NOT to do spinal manipulation...hence my view on the problem itself. It's overutilized b/c it's been turned into a profession not b/c spinal manipulation has no benefit. People have been receiving manipulation for thousands of years in one fashion or another. However, now it's done EVERY time someone visits a chiro not when it's needed or beneficial. Similar to patients recieving antibiotics EVERY time they show up to a 'doc in a box' and have a sniffle. Why? B/C people expect it and ask for it and pay for it. Not b/c it's beneficial (who does cultures?) or needed. Just like MD/DO's are having to have the courage to say "no" b/c for the good of the greater population, D.C.'s need to say no too. But this will never happen. So what's my point? I don't have one just like you guys who argue this same topic over and over and over again. And most of the time without any chiropractors to post their rebuttle. It's like going to a Klan meeting to talk about civil rights. 🙄 🙄 🙄

Don't worry I'm leaving. Carry on.