Say to a chiropractor, or to another specialist?
We have chosen the simple way to handle the problem of PCP refusing to refer when the patient asks. We have the patient get a new doctor. I have a few doctors in town that refuse to refer and what I do is have the patient switch to my own personal "chiropractic friendly" doctor. He has no problem writing referrals and actually loves the additional business.
Bottom line dude, if Chiropractic professionals had the same background in the basic sciences, proved they could score a decent MCAT score, and were residency trained after 4 hard years of full body-system education, then they would be respected. But oooops, I forgot, we already have individuals with this training, and they are called DO's with Board Certification in Manipulative Medicine. There were pre-"Chiro" people in all my undergrad science courses, and they were never very sharp unfortunately. And FYI, there is no requirement that a PCP generate ANY referral that he/she does not agree is needed. It is no different than refusing to send the 13 year old girl with mild acne to the dermatologist simply because her mother thinks she needs one. Patients often think they need specialists for every problem, but it is the PCP's job to treat within their scope of knowledge and then refer out. Funny enough, many patients automatically think that when they have back pain that they need a Chiro, so they come asking us if they can go. Then we tell them that they have to be given an "out of network" referral by us, and that they may be forced to pay the Chiro bill once the diagnosis does not fit with what the insurance company allows someone to see a Chiro for. The vast majority of our patients who's insurance actually would allow them to see a Chiro could only go if a radiologist had disagnosed a subluxation by radiograph. Do you know how often a radiologist makes this diagnosis? Not very!! But even funnier, Chiro's seem to make this diagnosis routinely and it seems to be the "hallmark" bread and butter dysfunction they treat. Even in DO world, we don't generally ever diagnose a subluxation. Its just way too damn rare! But bottom line Backtalk, a PCP has way more clout than a Chiro on some insurance plan and you are never going to get an insurance company to be "UPSET" that one did not refer a patient to you. Every patient not sent to a Chiro via referral saves the insurance companies thousands, and they are happy to see it limited. So complain all you want, but your words will fall on deaf ears. Chiro's do Manip, but that is all they should be allowed to do. So basically, they are musculoskelatal specialists, worthy I suppose of the title doctor. Never will they be worthy of the title physician in any way in my humbled opinion.
End of my portion of this insane discussion.Originally posted by PACtoDOC
Hi Johnny,
Sorry to hear about your father's experience in the hospital. Mistakes like that do happen, and people do die from them. But much more good has come from the medical profession than bad, and this thread was more about a few people butting heads rather than 2 professions butting heads. If you read the initial posts on this thread, you will see that the argument was instigated by Backtalk because he was offended and basically lashed out at the reality of PCP's not referring to chiropractors. And if you read any of my posts in previous threads, you will see where I have even mentioned that I plan to hook up with a good chiropractor to send my patients to when my manip skills are not good enough. You being a chiro should understand why I chose Do over MD. I had been a PA for several years before going back to medical school, and I worked in a group practice with doctors of both degrees. I have always appreciated the empathy, patience, and care that comes from DO's I worked with, and I saw the profession to be one that was more for me. I was accepted to both degree programs, but being in primary care already, I knew the only thing that would add more to my tool belt if I wanted to stay in primary care was to learn additional skills. I would not have learned that in MD school, because an MD family physician practices no different than an family medicine PA, in terms of philosophy. Yes I chose to take the road of lesser understanding from the public and even stigma, but it was right for me. But that is where I am leaving this conversation with you, because it is pointless to go any further. Good luck and I wish you a fulfilling career.
Originally posted by timerick
Are there published studies in peer-review scientific journals which show the benefit of chiropractic vs medical/surgical intervention (not just chiropractic vs placebo)?
Originally posted by MacGyver
Yes there are. They generally show that chiro and medical intervention are about the same in terms of clinical outcome for low back pain. Surgical intervention was shown to be better than either medical or chiro intervention.
Originally posted by PACtoDOC
Surgery has been shown in study after study to be superior to manipulation or medication, but it is impossible to set up a study that is not biased. The problem is, you have serious problems going to the surgeon, so of course they will make progress. You wouldn't be operating on someone that you didn't think quite honestly would benefit, so more times than not the outcome is improved. Its like comparing apples and oranges.
Originally posted by MacGyver
Agreed, but the main point is that drugs and chiro were shown to be approx equal benefit.
Most low back pain resolves on its own anyways. Chiro and medicine dont really help they just provide an route for placebo effect to take hold.
Originally posted by Johnny69
Man, you talk a lot of bull****!
When it comes to Un-complicated, LBP, Chiropractic is many times superior to drugs. This is a fact.
It is so typical of you as a doctor to say "most lower back pain resolves on its own anyways", when you really should say, i really dont know what the hell im talking about.
Originally posted by MacGyver
Yeah, and it cures cancer too right?
You need to clean up your own profession and throw out the quacks before you take on the real doctors you *****.