Chiropractic Enters VA Hospitals

[PublicHealth]

Here's the story: http://www.amerchiro.org/government/va/062804.shtml

These jobs are paying pretty well, too:

Occupational Title:
Chiropractor
Position Title:
Physician- Chiropractor
Facility Name:
WEST HAVEN
Assigned To:
Sensory Rehabilitation Medicine Service-West Haven Campus
Job Number:
VHA689CHIR45176
Grade:
13 thru 15
Salary:
$75,039-$135,602 per annum (To Be Determined by the Professional Standards Board
Opening Date:
07/23/04
Closing Date:
08/15/04
Full Time:
Yes
Supervisory Status:
No
Required Forms:
Completed Curriculum Vitae
Position Summary:
The VA Connecticut Healthcare System is seeking a full-time Chiropractor to provide care at our Newington and West Haven Campuses. We seek a dynamic individual with outstanding academic and clinical experience, management skills and a desire to practice in an interdisciplinary environment. Applicants should show evidence of progressive, continuous, postgraduate education and the ability to advance and develop superior programs in education, clinical service and basic & clinical research.
Location Summary:
West Haven & Newington Campus of VA Connecticut Healthcare System
Position Requirements:
Candidates must have a doctor of chiropractic degree from an accredited program and have a current, full and unrestricted license and a minimum of 4 years of chiropractic practice.
Organization Address:
950 Campbell Avenue
Organization Contact:
Marianne Sabino
OrganizationPhone
(203) 932-5711 ex 2347
Announcement Number:
689-04-Chiro

Source: http://www.vacareers.com/jobdetails...&searchvar=all&OccupationalTitle=Chiropractor

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Members don't see this ad.

 

[ScottDoc]

Two possibilites here:

1. There will be a thousand applicants

2. There will not be good pool of applicants because DC's are lazy and do not have half of these requirements. Therefore there will only be 5 applicants from around the country!

 

[Cowboy DO]

Position Title:
Physician- Chiropractor

I thought the title 'Physician' was reserved for only those with an MD/DO. I understood that it was illegal to claim to be a physician with out one of those degrees. This might be on a state by state basis though. Either way, I dont really care. Just thought it was odd.

 

[PublicHealth]

I thought the title 'Physician' was reserved for only those with an MD/DO. I understood that it was illegal to claim to be a physician with out one of those degrees. This might be on a state by state basis though. Either way, I dont really care. Just thought it was odd.

It varies by state. Connecticut, the state in which the West Haven VA hospital is located, allows chiropractors to use the title "Chiropractic Physician," so it's not illegal.

 

[PublicHealth]

Two possibilites here:

1. There will be a thousand applicants

2. There will not be good pool of applicants because DC's are lazy and do not have half of these requirements. Therefore there will only be 5 applicants from around the country!

Whatever the case, DCs getting into the VA system is a positive step for the profession (no, I'm not a chiropractor). I'm curious to know if this is some kind of "Chiropractic Demonstration Project" designed to show that chiropractic services may be safely and effectively provided within a hospital-based setting, and that patients benefit from such services. Ultimately, I wonder if the goal of the American Chiropractic Association (ACA) is to have DCs on the staffs of hospitals throughout the country. First the VA system, then rehab hospitals, then outpatient medical clinics, etc. There are already several DCs on the staffs of major military hospitals, and many others employed by some rehabilitation hospitals.

Anyone know if the ACA or some group of DCs is collecting data on safety, efficacy, and patient outcomes related to chiropractic care in the VA system?

 

[ScottDoc]

sure

 

[PublicHealth]

sure

Care to elaborate?

 

[MacGyver]

chiropractic has been proven effective for exaclty 3 things:

1) back pain
2) headache
3) neck pain

I'm still trying to figure out why the hell you'd want to go to 4 years of college and 4 years of grad school, only to treat 3 conditions.

BTW, all the chiros who say they can cure deafness, autism, fertility problems, etc are lying.

90% of the field of chiro is quacks who believe in bogus treatemnts. The remaining 10% can only treat those 3 conditions listed above. I ask again, why the hell would you wanna drop 100k on college and 150k on grad school just to learn how to treat those 3 problems?

 

[awdc]

Whatever the case, DCs getting into the VA system is a positive step for the profession (no, I'm not a chiropractor). I'm curious to know if this is some kind of "Chiropractic Demonstration Project" designed to show that chiropractic services may be safely and effectively provided within a hospital-based setting, and that patients benefit from such services. Ultimately, I wonder if the goal of the American Chiropractic Association (ACA) is to have DCs on the staffs of hospitals throughout the country. First the VA system, then rehab hospitals, then outpatient medical clinics, etc. There are already several DCs on the staffs of major military hospitals, and many others employed by some rehabilitation hospitals.

No, this isn't a demonstration project. It's the real deal. The VA are now required to integrate chiropractic into their health care system. The demo project was around the time I was in chiro school back 3-5 years ago. Same thing with the military hospitals. That demonstration project came to an end around the same time and now the three branches of the armed forces are supposed to integrate chiropractors also.

 

[ScottDoc]

Mac-

My point exactly!

Chiros do believe in conservative care. However, a DO is (or can be) more qualified to render care. The main reason is the DO is a physician, plain and simple. DC's will argue that they can adjust the neck better, but what happens when that does not work? Referral! Lost income, lost contact AND (unfortunately) lost respect. That is the way it is.

Yes manipulation can be a great treatment for NMS conditions (only a few), but manipulation does not treat EVERYTHING! A DC cannot be a complete care physician.

The time and $$ is a waste.

 

[awdc]

chiropractic has been proven effective for exaclty 3 things:

1) back pain
2) headache
3) neck pain

I'm still trying to figure out why the hell you'd want to go to 4 years of college and 4 years of grad school, only to treat 3 conditions.

Same can be said for med school. Why go through all that only to treat the skin, or the heart, or the lungs, etc? In reality, there are numerous conditions associated with each region of the human body. Neck pain? It could be a disc herniation, DJD, status post-trauma, accel-decel injury (whiplash), torticollis, postural syndrome, etc. Headache? Is it a migraine, tension, or cluster? Some important things to rule out (although we don't treat) are a subdural bleed, tumor, and aneurysm. With back pain, you could have some of the same problems as the neck such as a disc herniation, or other things such as altered biomechanics causing the back pain, or maybe a simple strain, scoliosis (I know, can't cure it but is certainly treatable for improved quality of life), or arthritis. Obviously, there's more but you get the idea.

 

[MacGyver]

Same can be said for med school. Why go through all that only to treat the skin, or the heart, or the lungs, etc?

Not a fair comparison. Going into medical school you have the potential to work in all those areas. The vast majority of doctors in the US are not specialists they are primary care docs like IM and FP. IM and FP deals with THOUSANDS OF CONDITIONS.

For chiro on the other hand, there are 3 and ONLY 3 relevant conditions in teh WHOLE DAMN PROFESSION!

In reality, there are numerous conditions associated with each region of the human body.

Irrelevant. Chiros arent trained to recognize/diagnose those things. Nor do they have anything in their treatment arsenal that can help with it. The ONLY thing they can provide is manual therapy for musculoskeletal issues related to headache, neck pain, and back pain.

Neck pain? It could be a disc herniation, DJD, status post-trauma, accel-decel injury (whiplash), torticollis, postural syndrome, etc.

This is irrelevant to the chiro, whereas it makes a difference to a real medical doctor. A real MD changes his treatment based on the etiology of the problem. The chiro ignores the etiology of the problem and treats all neckpain the same way: manual therapy.

Headache? Is it a migraine, tension, or cluster?

See above.

Some important things to rule out (although we don't treat) are a subdural bleed, tumor, and aneurysm.

Chiros not trained to "rule stuff out" they are only trained with how to treat those 3 problems.

They are SUPPOSED TO REFER OUT people who dont have a musculoskeletal cause of injury, but they certainly are NOT trained to come up with a differential diagnosis of all etiologies for the pain/injury.

 

[awdc]

Not a fair comparison. Going into medical school you have the potential to work in all those areas. The vast majority of doctors in the US are not specialists they are primary care docs like IM and FP. IM and FP deals with THOUSANDS OF CONDITIONS.

For chiro on the other hand, there are 3 and ONLY 3 relevant conditions in teh WHOLE DAMN PROFESSION!

Actually the majority of doctors are not primary care, although they may enter as IM or Peds. Depending on the source it varies around 30% primary care. And I probably should have mentioned this in my earlier post but chiros are also trained to treat other musculoskeletal disorders aside from HA, neck and back pain. But you know what, it still wasn't my cup of tea, hence I'm in medicine now.

Irrelevant. Chiros arent trained to recognize/diagnose those things. Nor do they have anything in their treatment arsenal that can help with it. The ONLY thing they can provide is manual therapy for musculoskeletal issues related to headache, neck pain, and back pain.

This is irrelevant to the chiro, whereas it makes a difference to a real medical doctor. A real MD changes his treatment based on the etiology of the problem. The chiro ignores the etiology of the problem and treats all neckpain the same way: manual therapy.

Chiros not trained to "rule stuff out" they are only trained with how to treat those 3 problems.

They are SUPPOSED TO REFER OUT people who dont have a musculoskeletal cause of injury, but they certainly are NOT trained to come up with a differential diagnosis of all etiologies for the pain/injury.

Actually, when I was in chiro school, I clearly remember learning how to recognize/diagnose non-musculoskeletal problems. And I do clearly remember changing my treatment plan according to the etiology and stage of the condition when I was an intern and when I was practicing. And I clearly remember having to come up with differential diagnoses but obviously, not to the depth that I'm learning in med school now.

Look, I'm not saying that what you learn in chiro school justifies the amount of money spent on it. Personally, I don't think the return on investment from chiro school is good at all. What I do have a problem with is the oversimplification of chiropractic education and training.

 

[MacGyver]

Actually, when I was in chiro school, I clearly remember learning how to recognize/diagnose non-musculoskeletal problems. .

So what did your professors tell you to do when you found a non musculoskeletal cause of neck pain?

Answer (if it was a legit school): they told you to refer out to a real medical doctor.

Answer (if it was a quack school, like 90% of the chiro schools out there): its a magic subluxation and your healing hands will cure them.

I'll say it again: non musculoskeletal causes of injury are IRRELEVANT to the chirorpactor, because THEY HAVE NO TREATMENT REGIMENS FOR NON MUSCULOSKELETAL INJURIES!

 

[awdc]

So what did your professors tell you to do when you found a non musculoskeletal cause of neck pain?

Answer (if it was a legit school): they told you to refer out to a real medical doctor.

Answer (if it was a quack school, like 90% of the chiro schools out there): its a magic subluxation and your healing hands will cure them.

I'll say it again: non musculoskeletal causes of injury are IRRELEVANT to the chirorpactor, because THEY HAVE NO TREATMENT REGIMENS FOR NON MUSCULOSKELETAL INJURIES!

Yes, you're right, we were taught to refer out. But without training in differential diagnosis we wouldn't know whether we are to refer to an office or the ED. Or, whether or not our therapy would have any adverse effect on a non-muculoskeletal condition.

IMO, not paying any attention to non-musculoskeletal etiologies is a recipe for disaster. No training in this would result in chiropractors making mistakes such as the refered pain of an aortic aneurysm as simply back pain. Differential diagnosis training is essential to being a safe pracititioner. Just as optometrists and dentists learn about things that they cannot treat, chiropractors should as well. And based on my experiences, the MDs (FPs, orthos, neuros) I've worked with really liked it when the chiro wasn't an idiot. It makes them more comfortable.

Still, I understand what you're saying about going to school for four years only to be able to treat a limited number of conditions (although to me, the depth of those limited conditions somewhat justifies the length of time... but not really). Is your argument the same for optometrists, dentists, and podiatrists? And fyi, I think you're greatly exaggerating when you say that only 10% chiro schools are "legit."

 

[BackTalk]

Why does this guy keep saying "real medical doctor"? Are there fake ones or something?


I'll say it again: non musculoskeletal causes of injury are IRRELEVANT to the chirorpactor, because THEY HAVE NO TREATMENT REGIMENS FOR NON MUSCULOSKELETAL INJURIES!

I agree with that. If someone comes in my office that was stabbed in the gut, there's not much I can do other than call the real paramedic who takes them in a real ambulance, to a real hospital so they can be seen by the real medical doctor.

The vast majority of doctors in the US are not specialists they are primary care docs like IM and FP. IM and FP deals with THOUSANDS OF CONDITIONS.

Jack of all trades yet a master of none.

For chiro on the other hand, there are 3 and ONLY 3 relevant conditions in teh WHOLE DAMN PROFESSION!

Wrong, Chiropractors treat more than three conditions.

Irrelevant. Chiros arent trained to recognize/diagnose those things. Nor do they have anything in their treatment arsenal that can help with it. The ONLY thing they can provide is manual therapy for musculoskeletal issues related to headache, neck pain, and back pain.

You are under the impression that chiropractic is synonymous with manipulation. Although this is our craft it's not our only tool in the tool box. Chiropractors are trained to diagnose those things. I should know I went to chiropractic school. We are trained to refer them out to the proper real specialist. An IM or FP does the same as they do not treat every condition that comes through the door.

This is irrelevant to the chiro, whereas it makes a difference to a real medical doctor. A real MD changes his treatment based on the etiology of the problem. The chiro ignores the etiology of the problem and treats all neckpain the same way: manual therapy.

The real medical doctor ignores the etiology of the problem and treats all neck pain the same way: DRUGS.

Chiros not trained to "rule stuff out" they are only trained with how to treat those 3 problems.

You obviously have no clue as to what chiropractic education entails.

 

[russellb]

The real medical doctor ignores the etiology of the problem and treats all neck pain the same way: DRUGS.

My own experience, BT, is that most MDs are happy to refer patients for manual therapy. I think that any primary care MD should (and most would) be comfortable referring patients to any of the Chiropractors involved in this discussion. Certainly, plenty of MDs refer NMS problems to physios as well. I don't think that any MD in his/her right mind sees pharmacologic therapy as anything beyond a temporising measure; I doubt that any of us see medication as a long term solution for NMS conditions. Moreover, It's nice if the primary care MD can correctly determine the etiology of a given NMS condition, but I don't think it's really a necessity as they have plenty of referral options.

 

[PublicHealth]

chiropractic has been proven effective for exaclty 3 things:

1) back pain
2) headache
3) neck pain

Hmm...wrong. Here's a more comprehensive list:

Arthritis
Achilles tendonitis
Ankle Injuries
Back Pain/Injuries
Bicepital Tendonitis
Bunions
Bursitis
Carpal tunnel syndrome
Compartment syndrome (Chronic)
De Quervains's tenosynovitis
Dupuytren's contracture
Foot pain/injury
Frozen shoulder or adhesive capsulitis
Gait Imbalances
Golfers/Tennis elbow (Tendonitis)
Golf Injuries
Hammer Toes
Hand Injuries
Headaches
Hip Pain
Ilio tibial band syndrome
Impingement syndromes
Joint dysfunction
Knee meniscus injuries
Knee Pain
Leg Injuries
Muscle pulls or strains
Muscle weakness
Myofascitis
Neck Pain
Nerve Entrapment Syndromes
Performance Care
Plantar Fascitis
Post surgical
Repetitive strain injuries
Rib Pain
Rotator cuff syndrome
Running Injuries
Scar Tissue Formation
Sciatica
Shin splints
Shoulder Pain
Sports Injuries
Swimmers Shoulder
Tendinitis
Tennis elbow
Thoracic outlet syndrome
Throwing Injuries
TMJ
Weight Lifting Injuries
Whiplash (Hyperextension/hyperflexion injury)
Wrist Injuries

 

[Johnny69]

chiropractic has been proven effective for exaclty 3 things:

1) back pain
2) headache
3) neck pain

I'm still trying to figure out why the hell you'd want to go to 4 years of college and 4 years of grad school, only to treat 3 conditions.

BTW, all the chiros who say they can cure deafness, autism, fertility problems, etc are lying.

90% of the field of chiro is quacks who believe in bogus treatemnts. The remaining 10% can only treat those 3 conditions listed above. I ask again, why the hell would you wanna drop 100k on college and 150k on grad school just to learn how to treat those 3 problems?

So where exactly are you obtaining your rock solid statistics about the chiropractic profession??? Or, would it be fair of me to assume that your statements are made out of prejudice, misunderstanding, a lack of knowledge and ignorance???

After reading through the rest of your posts in this thread, you have lead me to beleive you have very little validity in your position, given you clearly have no idea.

IM not sure of your motivations to make such obsurd blanket statements and slander the entire chiropractic profession.

And for the record, i am not a chiropractic student, nor a chiropractor, i have history in chiropractic education, however i am now a medical student, so you cant accuse me of bias or agenda.

 

[PublicHealth]

So where exactly are you obtaining your rock solid statistics about the chiropractic profession??? Or, would it be fair of me to assume that your statements are made out of prejudice, misunderstanding, a lack of knowledge and ignorance???

After reading through the rest of your posts in this thread, you have lead me to beleive you have very little validity in your position, given you clearly have no idea.

IM not sure of your motivations to make such obsurd blanket statements and slander the entire chiropractic profession.

And for the record, i am not a chiropractic student, nor a chiropractor, i have history in chiropractic education, however i am now a medical student, so you cant accuse me of bias or agenda.

Great post. MacGyver is a nuisance. He likes to stir up controversy instead of posting objective information. It's one thing if you're opinionated, it's another when you're an a**hole about it.

By the way, what made you decide to leave chiropractic?

 

[MacGyver]

Arthritis
Achilles tendonitis
Ankle Injuries
Back Pain/Injuries
Bicepital Tendonitis
Bunions
Bursitis
Carpal tunnel syndrome
Compartment syndrome (Chronic)
De Quervains's tenosynovitis
Dupuytren's contracture
Foot pain/injury
Frozen shoulder or adhesive capsulitis
Gait Imbalances
Golfers/Tennis elbow (Tendonitis)
Golf Injuries
Hammer Toes
Hand Injuries
Headaches
Hip Pain
Ilio tibial band syndrome
Impingement syndromes
Joint dysfunction
Knee meniscus injuries
Knee Pain
Leg Injuries
Muscle pulls or strains
Muscle weakness
Myofascitis
Neck Pain
Nerve Entrapment Syndromes
Performance Care
Plantar Fascitis
Post surgical
Repetitive strain injuries
Rib Pain
Rotator cuff syndrome
Running Injuries
Scar Tissue Formation
Sciatica
Shin splints
Shoulder Pain
Sports Injuries
Swimmers Shoulder
Tendinitis
Tennis elbow
Thoracic outlet syndrome
Throwing Injuries
TMJ
Weight Lifting Injuries
Whiplash (Hyperextension/hyperflexion injury)
Wrist Injuries

OK, mr. smart guy. I want a peer reviewed, double blind placebo controlled trial which PROVES chiro is effective for all those things.

 

[PublicHealth]

OK, mr. smart guy. I want a peer reviewed, double blind placebo controlled trial which PROVES chiro is effective for all those things.

Chiropractic research is just beginning to gain some ground. The allopathic profession's disdain for chiropractic has shut out the possibility of federal funding to conduct research on chiropractic interventions. However, with the establishment of the NIH Center for Complementary and Alternative Medicine, funding has become available, and clinical trials are underway (http://nccam.nih.gov/news/19972000/030398.htm).

Here's a sample:

http://nccam.nih.gov/clinicaltrials/chiropractic.htm

With a national research infrastructure in place, more clinical trials examining the efficacy of chiropractic are being conducted and will be conducted in the years ahead. For the time being, chiropractic care of the aforementioned conditions is based mostly on anecdotal reports and case studies. Nevertheless, chiropractors around the world are trained to treat such conditions using chiropractic and related treatment modalities.

As noted in the first link above, researchers from a variety of fields and backgrounds (D.C., M.D., Ph.D., etc.) are joining forces to systematically examine the efficacy of chiropractic in treating a range of medical conditions.

Here's a list of research articles of randomized clinical trials examining the efficacy of chiropractic in treating low back pain: http://nccam.nih.gov/health/chiropractic/index.htm#app1

Time, and increased RCTs, will tell if chiropractic is efficacious in treating all of the above conditions.

 

[Johnny69]

Great post. MacGyver is a nuisance. He likes to stir up controversy instead of posting objective information. It's one thing if you're opinionated, it's another when you're an a**hole about it.

By the way, what made you decide to leave chiropractic?

I chose to leave chiropractic, because it was not for me. I knew that when i went into chiropractic, that there was always the road that i may take towards medicine. I dont regret studying chiropractic though, because i met some great friends.

By the way, i dont think MacGyver is stirring up controversy, dont give him that much credit. His actions are really just a public display of stupidity.

If McGyver does indeed study med, or one day hopes to study med, then i wish his patients good luck, for their doctor is small minded.

 

[Johnny69]

OK, mr. smart guy. I want a peer reviewed, double blind placebo controlled trial which PROVES chiro is effective for all those things.

I see, it is ok for you to make un-researched, ignorant, un-supported remarks such as 90% of all chiropractors are quacks, and the remaining 10% can only treat 3 conditions, but when Public health drops a realistic list of possible conditions where chiropractic may be helpful, you demand peer-reviewed, double blind placebo controlled trials.... PLEASE, GIVES ME A BREAK!!!!

Please tell me you are joking... Where was it again that you received your vast knowledge of the profession??? The back of a cereal box???

 

[Johnny69]

Not a fair comparison. Going into medical school you have the potential to work in all those areas. The vast majority of doctors in the US are not specialists they are primary care docs like IM and FP. IM and FP deals with THOUSANDS OF CONDITIONS.

For chiro on the other hand, there are 3 and ONLY 3 relevant conditions in teh WHOLE DAMN PROFESSION!



Irrelevant. Chiros arent trained to recognize/diagnose those things. Nor do they have anything in their treatment arsenal that can help with it. The ONLY thing they can provide is manual therapy for musculoskeletal issues related to headache, neck pain, and back pain.



This is irrelevant to the chiro, whereas it makes a difference to a real medical doctor. A real MD changes his treatment based on the etiology of the problem. The chiro ignores the etiology of the problem and treats all neckpain the same way: manual therapy.



See above.



Chiros not trained to "rule stuff out" they are only trained with how to treat those 3 problems.

They are SUPPOSED TO REFER OUT people who dont have a musculoskeletal cause of injury, but they certainly are NOT trained to come up with a differential diagnosis of all etiologies for the pain/injury.

I cant beleive i just read that..... !!!!

McGyver, i think it is time you stopped posting in this thread, because all you are doing is showing how truely misguided and un-educated on the issue you are.

 

[MacGyver]

Hey Johnny,

it must be fun in chiro school to have to recruit your own patients huh?

 

[MacGyver]

For the time being, chiropractic care of the aforementioned conditions is based mostly on anecdotal reports and case studies.

Yeah, the same "case studies" run by quack chiro outlets like www.jvsr.com that supposedly prove that spinal manipulation cures INFERTILITY and asthma, among other things.

edited for the fools who cant fill in the blanks in context of a typo.

 

[Johnny69]

Hey Johnny,

it must be fun in chiro school to have to recruit your own patients huh?

I am not a chiropractic student, i am not a chiropractor, i am in medical school. I studied chiropractic as an undergraduate degree, and finished my education there, upon which i was accepted into Med school.

So to your list of stupid remarks i can add inability to read or follow conversations??

 

[BackTalk]

Yeah, the same "case studies" run by quack chiro outlets like www.jvsr.com that supposedly prove that spinal manipulation cures infedility and asthma, among other things.

Kind of like all the drug companies who fund their own research on the drugs they make.

 

[PublicHealth]

Yeah, the same "case studies" run by quack chiro outlets like www.jvsr.com that supposedly prove that spinal manipulation cures infedility and asthma, among other things.

Correct me if I'm wrong, but asthma and infertility are not on the aforementioned list.

What's infedility?

 

[Johnny69]

Correct me if I'm wrong, but asthma and infertility are not on the aforementioned list.

What's infedility?

I am sure he meant Infertility, even so, if he did mean infidelity, he spelt it incorrectly.

This has been an interesting discussion, however the only substance i have truely drawn from it though is that McGyver is a toss.

I am sure that if we were to conduct a peer reviewed, double blind placebo controlled study, that hypothesised 'that McGyver is indeed a toss, it would come up trumps!
I challenge anyone to prove me wrong.

 

[PublicHealth]

I am sure he meant Infertility, even so, if he did mean infidelity, he spelt it incorrectly.

This has been an interesting discussion, however the only substance i have truely drawn from it though is that McGyver is a toss.

I am sure that if we were to conduct a peer reviewed, double blind placebo controlled study, that hypothesised 'that McGyver is indeed a toss, it would come up trumps!
I challenge anyone to prove me wrong.

Hmm...chiropractic treatment for infidelity. I imagine that would involve having a chiropractor INDUCE a vertebral subluxation in the lower thoracic/upper lumbar region of the spine so as to block innervation of the sexual organs.

 

[MacGyver]

PublicHealth,

you didnt read the website very carefully.

http://www.jvsr.com/access/abstracts.asp?catalogid=188

http://www.jvsr.com/abstracts/index.asp?id=202

http://www.jvsr.com/access/abstracts.asp?catalogid=192

Go ahead, defend this outright quackery.

This is a prime example of the "case studies" and "research" your NCCAM reference was talking about. What a ****ing joke.

Search teh entire PubMed database and you will find randomized double blind placebo controlled trials for chiro in ONLY the 3 following areas: back pain, neck pain, and headaches.

Go ahead, find me a PubMed reference to an RCT which deals with ANY of the other conditions you mentioned. I double dog dare you. You'll be searching for a long time.

 

[PublicHealth]

PublicHealth,

you didnt read the website very carefully.

http://www.jvsr.com/access/abstracts.asp?catalogid=188

http://www.jvsr.com/abstracts/index.asp?id=202

http://www.jvsr.com/access/abstracts.asp?catalogid=192

Go ahead, defend this outright quackery.

This is a prime example of the "case studies" and "research" your NCCAM reference was talking about. What a ****ing joke.

Search teh entire PubMed database and you will find randomized double blind placebo controlled trials for chiro in ONLY the 3 following areas: back pain, neck pain, and headaches.

Go ahead, find me a PubMed reference to an RCT which deals with ANY of the other conditions you mentioned. I double dog dare you. You'll be searching for a long time.

MacGyver,

I agree that some of these chiropractic studies may go a bit overboard, but that does not mean you should discredit them outright. As indicated above, chiropractic research is just beginning to take form. Moreover, the authors of these reports clearly indicate that more research needs to be done and that their results should not be taken as conclusive. For example:

"The pilot study provides only preliminary, limited empirical data. Consequently, while further study is suggested, the results, though high in consistency and magnitude of clinical effect (effect size) and similarity regarding duration of care prior to subjective reporting of initial improvement must be interpreted cautiously" (So et al., 2004).

"The small number of subjects and the cohort study design limit the conclusions that can be made from this data. However, this data is clearly strong enough to justify a larger, more well-controlled clinical trial to determine the extent of efficacy of Toftness chiropractic adjustment at treating this widespread childhood condition" (Zhang & Snyder, 2004).

And what's so controversial about thinking that otitis media may be treated with manipulative therapies such as chiropractic? A recent article in one of the journals of the American Medical Association actually found that osteopathic manipulation may be a helpful adjuvant therapy in treating children with recurrent acute otitis media:

The use of osteopathic manipulative treatment as adjuvant therapy in children with recurrent acute otitis media.

Mills MV, Henley CE, Barnes LL, Carreiro JE, Degenhardt BF.

Department of Pediatrics, Oklahoma State University Center for Health Sciences, Tulsa 74107, USA. [email protected]

OBJECTIVE: To study effects of osteopathic manipulative treatment as an adjuvant therapy to routine pediatric care in children with recurrent acute otitis media (AOM). STUDY DESIGN: Patients 6 months to 6 years old with 3 episodes of AOM in the previous 6 months, or 4 in the previous year, who were not already surgical candidates were placed randomly into 2 groups: one receiving routine pediatric care, the other receiving routine care plus osteopathic manipulative treatment. Both groups received an equal number of study encounters to monitor behavior and obtain tympanograms. Clinical status was monitored with review of pediatric records. The pediatrician was blinded to patient group and study outcomes, and the osteopathic physician was blinded to patient clinical course. MAIN OUTCOME MEASURES: We monitored frequency of episodes of AOM, antibiotic use, surgical interventions, various behaviors, and tympanometric and audiometric performance. RESULTS: A total of 57 patients, 25 intervention patients and 32 control patients, met criteria and completed the study. Adjusting for the baseline frequency before study entry, intervention patients had fewer episodes of AOM (mean group difference per month, -0.14 [95% confidence interval, -0.27 to 0.00]; P =.04), fewer surgical procedures (intervention patients, 1; control patients, 8; P =.03), and more mean surgery-free months (intervention patients, 6.00; control patients, 5.25; P =.01). Baseline and final tympanograms obtained by the audiologist showed an increased frequency of more normal tympanogram types in the intervention group, with an adjusted mean group difference of 0.55 (95% confidence interval, 0.08 to 1.02; P =.02). No adverse reactions were reported. CONCLUSIONS: The results of this study suggest a potential benefit of osteopathic manipulative treatment as adjuvant therapy in children with recurrent AOM; it may prevent or decrease surgical intervention or antibiotic overuse.



You should also keep in mind that randomized controlled trials are not the "be all, end all" of clinical or scientific evidence. In fact, the idealistic, controlled nature of clinical trials often limits their ecological validity.

 

[awdc]

OK, mr. smart guy. I want a peer reviewed, double blind placebo controlled trial which PROVES chiro is effective for all those things.

So much of what we use to treat those conditions are actually the same interventions used by physical therapists. Take a look in the PT journals and texts also. Chiropractic research naturally focuses on spinal manipulation. Remember, chiropractic does not equal spinal manipulation. The whole range of "chiropractic" interventions include therapeutic exercises, manual therapies including manipulation, physical therapy modalities, lifestyle education, etc.

 

[MacGyver]

Yeah yeah I know chiros have all these "tools" in their arsenal to use.

Things like the "activator"

This video documentary on chiropractic is hilarious: http://www.pbs.org/saf/1210/video/watchonline.htm

 

[DOctorJay]

I cant beleive i just read that..... !!!!

McGyver, i think it is time you stopped posting in this thread, because all you are doing is showing how truely misguided and un-educated on the issue you are.

Why don't you all just stop posting in this ENTIRE FORUM - this is the PHYSICAL THERAPY FORUM!!!

 

[PublicHealth]

Why don't you all just stop posting in this ENTIRE FORUM - this is the PHYSICAL THERAPY FORUM!!!

Yes, and chiropractic is a form of physical therapy! Don't hate! Several of us contacted the SDN Moderator to set up a Chiropractic (DC) forum, but nothing has happened. Thus, those of us interested in discussing issues related to chiropractic are posting in the PT forum.

The issues concerning chiropractic that are raised in this forum are highly relevant to physical therapy, as both fields seem to be rivals of a sort and tend to use comparable approaches in treating neuromusculoskeletal conditions. Moreover, administrative happenings such as DCs getting on the staffs hospitals also affect PTs, as departmental structures may begin to change. It's too early to tell, but the rehabilitation field will look drastically different several years from now, especially with a new clinical doctorate (DPT) in physical therapy, increased visibility of DCs in hospitals, and increasing government and public interest in alternative medicine and manipulative therapies.

As Thoreau put it, "The universe is wider than our views of it."

 

[DOctorJay]

Yes, and chiropractic is a form of physical therapy! Don't hate! Several of us contacted the SDN Moderator to set up a Chiropractic (DC) forum, but nothing has happened. Thus, those of us interested in discussing issues related to chiropractic are posting in the PT forum.

The issues concerning chiropractic that are raised in this forum are highly relevant to physical therapy, as both fields seem to be rivals of a sort and tend to use comparable approaches in treating neuromusculoskeletal conditions. Moreover, administrative happenings such as DCs getting on the staffs hospitals also affect PTs, as departmental structures may begin to change. It's too early to tell, but the rehabilitation field will look drastically different several years from now, especially with a new clinical doctorate (DPT) in physical therapy, increased visibility of DCs in hospitals, and increasing government and public interest in alternative medicine and manipulative therapies.

As Thoreau put it, "The universe is wider than our views of it."

First off I'm not hating on DCs by saying that the discussion on this board should relate primarily to PTs. Some of the issues raised do indeed relate but when entire threads go on without any discussion of PT it doesn't belong here.

Next, chiropractic is by no means a type of physical therapy. Physical therapy is a profession unto itself - manipulation and mobilization are part of our practice but we do not claim to perform chiropractic (because that is lying). The state of NJ states that any person offering, billing for, or advertising physical therapy services without one of the following licenses (PT, PTA, MD, DO, DPM, DDS, DMD) is performing unlicensed practice (no DC there). I am also familiar with the practice acts of CT and LA and know that they read similarly.

Chiropractors are not allowed to advertise their treatments as physical therapy just as physical therapists cannot claim to be performing chiropractic treatment. However, many chiropractors do claim to provide physical therapy and I don't know any PTs who claim to provide chiropractic and this is where a lot of animosity from PTs comes from.

-J

 

[PublicHealth]

First off I'm not hating on DCs by saying that the discussion on this board should relate primarily to PTs. Some of the issues raised do indeed relate but when entire threads go on without any discussion of PT it doesn't belong here.

Next, chiropractic is by no means a type of physical therapy. Physical therapy is a profession unto itself - manipulation and mobilization are part of our practice but we do not claim to perform chiropractic (because that is lying). The state of NJ states that any person offering, billing for, or advertising physical therapy services without one of the following licenses (PT, PTA, MD, DO, DPM, DDS, DMD) is performing unlicensed practice (no DC there). I am also familiar with the practice acts of CT and LA and know that they read similarly.

Chiropractors are not allowed to advertise their treatments as physical therapy just as physical therapists cannot claim to be performing chiropractic treatment. However, many chiropractors do claim to provide physical therapy and I don't know any PTs who claim to provide chiropractic and this is where a lot of animosity from PTs comes from.

-J

Semantics.

 

[MSHARO]

It is illegal in Missouri for chiropractors to advertise PT as well. It is legal in Indiana which is total crap. If it is just semantics....why do DC's get all up in arms about PT's using manual therapy? Especially regarding law suitd like the one Arkansas. They sued a physical therapist for performing spinal mobilizations. Should PT's file a law suit every time a chiropractor gives out exercises? And there is a VERY BIG difference between chiropractors and physical therapists.

 

[DOctorJay]

Semantics.

Exactly, semantics for chiropractors who don't enjoy the excellent reputation that we PTs have (general overarching statement and I do recognize that some DCs out there are excellent and have excellent reputations). If you were actually a member of one of these professions as opposed to a fan of one of them you might understand.

-J

 

[PublicHealth]

Exactly, semantics for chiropractors who don't enjoy the excellent reputation that we PTs have (general overarching statement and I do recognize that some DCs out there are excellent and have excellent reputations). If you were actually a member of one of these professions as opposed to a fan of one of them you might understand.

-J

You fool! Why do you think APTA is pushing for all PTs to obtain a DOCTORATE in physical therapy!? Are they not satisfied with the "excellent reputation" that PTs have? Is the level of education needed to be a PT really of the doctorate level or is the financial and professional visibility of PT in question? Oh, and why are you, a PT who speaks of such an "excellent reputation" of your respective field, going to osteopathic medical school? Were you getting tired of pulling overweight people out of bed all day and moving their legs for them, or were you frustrated with the lack of autonomy in the PT field that has such an "excellent reputation?"

Legal definitions aside, there is a lot of overlap in the services that chiros and PTs provide. This, at least in part, explains the "turf wars" that have plagued both professions over the years. It also completely explains why I have and why I will continue to post threads concerning chiropractic in the PT forum.

 

[MSHARO]

I will agree that there are good DC's out there, but I think the main problem is that there is a large majority that overstep their bounds. When 1-2/10 in a profession are good....that sounds kinda shady to me. You don't hear too much about how many unethical/over billing PT's there are, even though there are a few of them out there.

We had a DC that regularly referred to us and vice versa, and it worked well. When he knew that the patient was more of a rehab canidate, he sent them over. When we weren't getting any where with our rehab and manual techniques, we'd send them over to him. It worked well and we respected each other. But that was pretty rare. When a chiropractor starts spouting off about how they know so much about rehab, it makes me sick.

There are definately turf wars between the two, but it pretty much all comes down to money. Since the chiropractors have had a "higher" degree, they seem to have a little more clout, plus more money and better lobbyists. The APTA is just trying to level the playing field so things can be a little more equal when that discussion comes about. If they can have direct access why can't we? Especially if there is a great deal of overlap? At least PT is making a huge push towards evidence based practice and adjusting the profession accordingly.

And on another note, not all of us who are going to medical school are "tired of pulling overweight people out of bed all day and moving their legs for them, or were you frustrated with the lack of autonomy in the PT field that has such an "excellent reputation?" Maybe some of us just had different interest. I have just been fascinated with surgery and would like to spend everyday doing that. When I got into PT school I just found the classes and the info so fascinating and useful that I couldn't quit. I just knew that it would be an excellent background for me.

As for autonomy...I think that as a PT I have a great deal of autonomy. Or at least I did. I had a good enough relationship with our docs that they pretty much let me do what I wanted. Which is the way that it should be. Sure...if there is something specific about a surgery that doc wants protected or if they think should be worked on, fine...but don't start telling me about specific exercises etc. Physicians just aren't trained in that. The one's that refer to me, seem to realize this. Again, the only reason many of us are going back is not just because we aren't satisfied with the autonomy.

 

[DOctorJay]

You fool! Why do you think APTA is pushing for all PTs to obtain a DOCTORATE in physical therapy!? Are they not satisfied with the "excellent reputation" that PTs have? Is the level of education needed to be a PT really of the doctorate level or is the financial and professional visibility of PT in question? Oh, and why are you, a PT who speaks of such an "excellent reputation" of your respective field, going to osteopathic medical school? Were you getting tired of pulling overweight people out of bed all day and moving their legs for them, or were you frustrated with the lack of autonomy in the PT field that has such an "excellent reputation?"

Legal definitions aside, there is a lot of overlap in the services that chiros and PTs provide. This, at least in part, explains the "turf wars" that have plagued both professions over the years. It also completely explains why I have and why I will continue to post threads concerning chiropractic in the PT forum.

Actually I am very interested in furthering my education and being able to provide complete care for patients (as a PT I would not be able to do this, neither would a DC). My statement concerning reputation was related to the general public's regard for PT as a profession. I said nothing about autonomy or doctorate degrees both of which have nothing to do with the reputation of PT (notice many PTs don't have doctorates yet and we still have a better public standing than chiros who do have doctorates).

Finally, I have been a member of the APTA for the past 4 years. I have been to numerous conferences and student conclaves. I have also had the opportunity to speak with and hear where this profession is headed and why from the people moving the profession forward. The whole purpose behind the DPT is indeed to increase autonomy which wasn't afforded to us for absurd reasons (note that OTs have complete autonomy and may practice without physican referral).

I'm sure most of these discussions could be much more informative and I wouldn't mind your posting in this forum if you weren't so condescending towards anyone who has something to say that contrasts your opinion.

-J

 

[PublicHealth]

Why don't you all just stop posting in this ENTIRE FORUM - this is the PHYSICAL THERAPY FORUM!!!

I'm sure most of these discussions could be much more informative and I wouldn't mind your posting in this forum if you weren't so condescending towards anyone who has something to say that contrasts your opinion.

You're the one who is trying to render chiropractic discussions obsolete.

Now that we've gotten our swings in, let's kiss and make up, and get on with discussing issues in PT, chiropractic, and the rehabilitation profession in general. There are many, so let's stop wasting space in this forum with ad hominem attacks.

 

[DOctorJay]

Fine with me, and for the record I wasn't saying that chiropractic discussion does not belong here, I stated that when it's SOLELY related to chiropractic it doesn't belong in the physical therapy forum.

On with the show.

 

[delicatefade]

And on another note, not all of us who are going to medical school are "tired of pulling overweight people out of bed all day and moving their legs for them, or were you frustrated with the lack of autonomy in the PT field that has such an "excellent reputation?"

I don't know what setting you guys worked in, but I got tired of this pretty quick. It's been one of my motivating factors to go back to medical school, among other things.

 

[PublicHealth]

I don't know what setting you guys worked in, but I got tired of this pretty quick. It's been one of my motivating factors to go back to medical school, among other things.

Exactly.

 

[MSHARO]

No offense, but you shouldn't have worked in that setting then. I worked outpatient ortho and haven't had to get someone out of bed in a few years. I just hope that is not the main reason that you are getting out of physical therapy, because there are MANY settings where your aren't just pulling people in and out of bed. (Outpatient ortho/neuro, peds, etc.) Work acute care, of course you are going to be doing that, but it comes with the territory. I never liked that, so I didn't take a job in that setting. Simple enough. But that had absolutely nothing to do with why I am going back to medical school.