Chiropractor Or Do

[Wizard of Oz]

Besides, the basic chiropractic philosophy is flawed - I don't care how many times you put Mary Lou "back in alignment" it still won't cure Mary Lou's gonorrhea.

I think that she might have gotten that idea since I threw her back out of alignment while giving her gonorrhea.

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[Orthonut]

ohh crap...



*popcorn-check, soda-check*

Why do the interesting (read: Train Wreck) threads always happen when I am in class/lab ALL DAY LONG and don't even have time to check emails? Sheesh. I'd have had hours of entertainment on this one...

*O'Nut settles into comfy chair*

Chiropractors are great at what they do. They have one modality to treat certain ailments, and as long as they stick to what they know best, I think they do a lot of good. It's when they try to use that modality to treat problems that are out of their level of training that problems arise.

Hmm. I'd be nervous about someone cracking my spine and all but I see your point-stick to what you know, etc, right?

This is the same as asking if anyone considered being a space ninja before medicine which obviously many of us did before our dreams were shattered and we settled for being docs.

Nate! How did you know I wanted to be a space ninja before my dreams were cruelly dashed and I had to settle for being a DVM?

This is my most favourite thread ever!

 

[Dr.Inviz]

Why do the interesting (read: Train Wreck) threads always happen when I am in class/lab ALL DAY LONG and don't even have time to check emails? Sheesh. I'd have had hours of entertainment on this one...

*O'Nut settles into comfy chair*

u missed the party ... move outta the way, time to clean up

 

[Familyties]

its better to do do period!

 

[91z4me]

Comparing DO and DC degrees is impossible.You might as well compare DO degrees with Cosmetology.

There's a reason why chiropractors are not allowed to prescribe medication or perform any surgery and it's not due to "natural" healthcare philosophy - it's a result of competence and education.

No it is because it is outside of their scope of practice and because it goes against their philosophical construct. Seems like you don't know much, so this may be a long post.

I've practiced for 20 years (Board Certified in Family Practice) - chiropractors are almost universally seen as bumbling back and body crackers who are basically harmless when treating patients who have 1) limited intelligence or understanding of medicine and 2) will get better anyway after whatever it is goes away on its own.

So perception by the un-educated public is what is true?

Too many chiropractors have limited skills in differential diagnosis and a rudimentary knowledge of pharmacology - I'm not sure what role they play in health care aside from overbilling.

I disagree with skills in differential diagnosis but until either of us show proof it is 1 person vs another. As far as having knowledge of pharmacology, why would they need to know about it? They don't use it! It would be like saying your knowledge of heart surgery is rudimentary. It doesn't matter because it isn't what you do.

And I woudln't say DCs overbill when was the last time one charged you $40 for an Tylenol?

Besides, the basic chiropractic philosophy is flawed - I don't care how many times you put Mary Lou "back in alignment" it still won't cure Mary Lou's gonorrhea.

Right an infection is an infection and only the body's natrual immunity or introduced medicine can help with that but I don't think your in a qualified position to know the ins and outs of Chiropractic philosophy so I don't think you can call it flawed.

I used to have patients bring me lab reports from studies their chiropractors would order because the chiros couldn't interpret the results.

And I know for a fact that some DCs have patients bring them lab reports for interpretation because either the explanation offered by the party who ordered it wasn't sufficient or no explanation was given. There are bad eggs in every basket.

If your mom had diabetes would you tell her to stop the insulin and get a couple of "lumbar rolls?"

Yeah and you would know how?

Seriously, even though chiropractic makes virtually no sense now, it was probably acceptable in 1895. It's been downhill from there. Chiropractors offer a simple explanation for complex problems ("...your headaches are because this vertebra is misaligned - I'll fix that" ...CRACK! CRUNCH!).

Well DCs could go into a 10 minute discussion of amazing detail about how they are doing what they are and why it does what it was. But then they would need to do quite a bit of explanation of explanation because the general public doesn't operate on the same level that DCs, DOs, or MDs do. It is called knowing your audience and being able to communicate with them.

Granted, some chiropractors spare patients from medical errors, toxic drugs, or an over-aggressive health care system but all things being equal the profession should probably be shut down.

Why should it be shut down? Because you don't understand it and you don't see the good that it does? Or because you think they are a threat to your pratice and your future?

If all the chiropractors suddenly disappeared tomorrow what real harm would befall the American public? I know that sounds harsh but in the final analysis my advice would be to avoid DC schools like the plague, which chiropractors can't treat anyway.

If all DOs disappeared tomorrow what would be the effects? I mean really. Would it not be about the same? People would go elsewhere for management of their healthcare condidtions. Some would find treatment that was just as good and some wouldn't.

While I was taught osteopathic manipulation (which is in many ways different than chiropractic manipulation) I don't have to use it if I don't consider it clinically helpful. Chiropractors have no choice. Then again, they probably don't know other choices exist.

And that means what? DCs treat what they know, how they know. You treat what you know and you treat it how you know it. Just because you approach things from 2 different prospectives doesn't mean that 1 is automatically wrong and the other is automatically right. Heck they could both be wrong. BTW I really doubt that the manipulations you know could even represent the over 100 techniques of chiropractic (and yes I know that there is no way for a single DC to know all of those techniques but they are out there and avialable to patients) that are available so lets not try to compare it, OK?

 

[FoughtFyr]

And that means what? DCs treat what they know, how they know. You treat what you know and you treat it how you know it. Just because you approach things from 2 different prospectives doesn't mean that 1 is automatically wrong and the other is automatically right. Heck they could both be wrong. BTW I really doubt that the manipulations you know could even represent the over 100 techniques of chiropractic (and yes I know that there is no way for a single DC to know all of those techniques but they are out there and avialable to patients) that are available so lets not try to compare it, OK?

O.k., I'm an MD, who goes to a DO as his PCP. There is a simple fact you are overlooking (as do most MDs). Since the Flexner report there has, in fact, been very little difference between MDs and DOs. Both traditional medicine and osteopathy were brought into a standardized method of education that insured (to some degree) that all providers were equal in their approach to patients.

There is no such standard in chiropractic. There are "straight" chiropractors who hold dear the principles of Palmer and the belief that nervous system dysfunction holds the key to most health problems. Then there are the "mixers" who agree that there is little scientific basis for most of Palmer's theories, but who feel chiropractic is a useful modality for treatment neuro/muscular/skeletal problems. Then there are the "psuedo-mixers" who hold on to Palmer's theories and try and expand them through "new" and decidedly non-medical practices. These folks are often very "anti-medicine" and truly believe that the "Rosetta Stone" to all of health lay within their grasp.

These groups infight so much that it is impossible to even define chiropractic care anymore because the care you will recieve will vary so greatly based on which "camp" your practitioner comes from.

Additionally, te training for chiropractors is nowhere close to that which physicians get. The closest physician, in terms of practice, to a chiropractor is a physiatrist. The physiatrist is required to have four years of medical school, 1 year of internship, and three years of residency training. Now, chiropractors will try and tell you that they somehow cram 5 years of training into 3 years. This is because they use the federal financial aid rules to define a year (1 year = 2 semesters). By this math, a physiatrist has 11 1/2 "years" of training.

Also, understand that, while they are properly referred to as "doctors" in practice, the DC is not generally recognized as an academic degree. There are many teaching hospitals where a DC would not be referred to as "doctor" (there are policies stipulating who can and can't be called "doctor" to prevent confusing patients and staff). There are no institutions of higher education, other than chiropractic colleges, where a DC is an acceptable degree for admission to academic faculty. (And before everyone starts screaming about T. Yochum at Colorado, he lectures there, he is not a professor, he is not on tenure track, and he does not hold academic rank. Nurses, paramedics, PTs and RTs hold similar positions at many schools. That doesn't make them faculty).

Additionally, chiropractic is not supported by the current literature for any condition other than idiopathic LBP. For that condition, studies have demonstrated that chiropractic is "as good as" but not better than traditional medical treatment. You should keep in mind that both chiropractic and traditional medicine are statistically only slightly better than placebo in those cases, so there is not a strong arguement for either. Read this for a bit more skeptical take on chiropractic education: http://quackfiles.blogspot.com/2005/02/why-i-left-chiropractic.html

There are several papers out that demonstrate how ineffectively chiropractors are prepared for practice in primary care, the best of which is here: http://www.ncbi.nlm.nih.gov/entrez/..._uids=15965408&query_hl=1&itool=pubmed_docsum

What they did was give a test to on basic primary care to three groups of chiropractic students in their final terms in chiropractic college (groups 1, 2 and 3) and one group of recent medical school graduates who had yet to start residency. The test was created by "2 DCs who also hold bachelor's degrees, 1 DC with a diplomate in radiology, a DC enrolled in the final year of a radiology residency program, and 2 MDs". It was a 100 question test broken into two 50 question sections and some description of attempts to validate the instrument for use on chiropractic students is offered by the authors. So here is what they found...

Group 1: 21 students, raw scores 32.7, % scores 65.4, SD 4.6
Group 2: 22 students, raw scores 28, % scores 56, SD 5
Group 3: 79 students, raw scores 32.1, % scores 64.2, SD 4.4
Groups 1 to 3 (combined): 122 students, raw scores 31.4, % scores 62.8, SD 4.7
Group 4: 20 students, raw scores 36.7, % scores 73.4, SD 3.3

Now, while the medical student sample size is low, the performance of the chiropractic students is abyssmally low. 68% of all of the chiropractic students (who are very soon to enter practice) taking the test, a test designed and validated by DCs, scored between 58.1% and 67.5%?!? This is noteworthy? Yes, it is! It succinctly proves the point that DCs are very ill prepared to serve as primary care physicians. As for the medical students, 68% scored between 70.1% and 76.7%. While I would normally bristle at these data as the sample size is so small, it should be noted that the SD was the narrowest, by a considerable amount, in this group. This leads me to question the need to validate the instrument not only with chiropractic students (as was done) but also with medical students (not done in this study). These results seem to indicate a very tight "clumping" of scores in the medical student group, which may suggest that areas of the test represented material outside their scope of instruction.

Other results:
Percentage scores of all students on 5 major categories of primary care tasks
Primary care activities (% correct)
Information gathering Group 1 - 60.12, 2 - 57.04, 3 - 64.72, 4 - 76.64
Screening and prevention Group 1 - 35.72, 2 - 27.09, 3 - 38.93, 4 - 63.10
Other diagnostic procedures Group 1 - 66.94, 2 - 57.64, 3 - 65.83, 4 - 74.34
Counseling and education Group 1 - 69.05, 2 - 75.00, 3 - 87.74, 4 - 95.24
Management of acute/chronic conditions Group 1 - 65.71, 2 - 57.04, 3 - 64.69, 4 - 73.01

By these data, chiropractic does not perform information gathering or screening and prevention well at all.

I'm not going to post the data on all individual "subcategories of management of acute and chronic conditions". Suffice it to say that group four handily out performed all of the other groups in every area except one:
Musculoskeletal (% correct) Group 1 - 71.04, 2 - 56.95, 3 - 54.75, 4 - 48.02
(but group four did outperform the others in neuro!:
Neurological (% correct) Group 1 - 78.1, 2 - 61.67, 3 - 78.99, 4 - 82.86)

My most significant concern on their methodology is this - the test was given to medical students about to enter residency training and to final term chiropractic students about to enter practice (presumably). Now, the article acknowledges a gap, but that gap should only grow as the medical students have at least three years of training remaining. Also, no attempt was made to identify what area of medicine the MD students were entering. I would argue that given the latitude to self direct fourth year cirricula to a certain degree, students heading into primary care would likely outperform a random sample from all medical students on this examination as they would have more training in this area than the "average" medical student.

Lastly, the conclusions (from the abstract) do not match the data. It is not "noteworthy", in a positive sense, that chiropractic students about to enter the workforce score abyssmally low on a test of basic primary care skills. Comparing them to MD graduates with at least three years of training remaining is comparing apples and oranges. And even given the disparity in time remaining in training, the MD students quite significantly outperformed the chiropractors. This paper completely demonstrates what I have been saying since I started coming to this forum. Chiropractors are not equipped to act as primary care physicians.

Now chiropractors love to quote this study: http://www.ncbi.nlm.nih.gov/entrez/...t_uids=9801210&query_hl=5&itool=pubmed_docsum and it's follow-up http://www.ncbi.nlm.nih.gov/entrez/..._uids=15687152&query_hl=3&itool=pubmed_docsum as "proof" that MDs are not adequately trained in NMS complaints, and that chiropractors are. Before you buy into this realize the following - chiropractors were not given the test in either study! We have no idea how badly they would have bombed it. But we do know from the article above: J Manipulative Physiol Ther. 2005 Jun;28(5):336-44. Assessment of knowledge of primary care activities in a sample of medical and chiropractic students. Sandefur R, Febbo TA, and Rupert RL. that three groups of chiropractic third year students, when given a test on musculosketal pathology, scored 71.04%, 56.95%, and 54.75% respectively. So much for the greater musculoskeletal training.

And, the arguement is spurrious on its face. The articles on allopathic musculosketal pathology training were studies designed specifically to call for additional training for all physicians in musculosketal pathology. There is no question that the current medical school cirriculum is overloaded. The call for extended training in many subjects has been going on for years. Unlike in chiropractic where all of medicine AND all of chiropractic can be learned in three calendar years.

Given the collaborative medical model (remember that unlike chiropractors, MD/DOs do not believe we know everything nor do we believe we can treat everything) a properly treated patient presenting to a primary care physician for treatment of a musculosketal issue will be referred to another physician. Patients are best served by receiving care from a health care provider with more musculoskeletal training - an orthopedic surgeon or a medical PM&R physician.

BTW - the practicing orthopods ALL passed the test and were used as controls!

- H

 

[FoughtFyr]

If anyone wants a look at some of the evidence base (or lack thereof) that has been discussed regarding chiropractic elsewhere on this site...


OP: http://forums.studentdoctor.net/showpost.php?p=2687469&postcount=49

"Archives of Pediatrics & Adolescent Medicine

----------------------------------------------
Volume 151(5) May 1997 pp 527-528"

OP: http://forums.studentdoctor.net/showpost.php?p=2687469&postcount=48

"For example, there is a study which I have posted many times that suggested that 17% of chiropractors who identified themselves as treating children would treat a case of neonatal fever without referral to an MD/DO or more appropriately to an ED. (see: http://www.ncbi.nlm.nih.gov/entrez/...d&dopt=Abstract&list_uids=10768681&query_hl=8 ) Neonatal fever is a defacto emergency. No attempt should be made to treat as an outpatient – yet 17% of chiropractors who treat children would try."

OP: http://forums.studentdoctor.net/showpost.php?p=2561300&postcount=1

"Even SCARIER..."

http://www.jcca-online.org/client/cca/JCCA.nsf/objects/V49-1-46/$file/jcca-v49-1-046.pdf" - A chiropractic journal no less!

OP: http://forums.studentdoctor.net/showpost.php?p=2573803&postcount=19

"Now chiropractic and stroke."

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

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

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

from:http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=12466778 - Your favorite journal; JMPT (that fun lovin' group of chiro-bashers!)

"I thought there were "no side effects" to chiropractic? Yep it never happens, but the chiropractic journals describe when and how. I guess they are used to reporting on fictional things (like subluxations) anyway..."

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

"To be fair, there is an article describing why there is such a different opinion of the level of risk chiropractic manipulation represents."

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

OP: http://forums.studentdoctor.net/showpost.php?p=2605708&postcount=59

"Great, now we are paying for "unproven" methods to be available to all. You know, given the amount of the population that screams "I can't afford health care" this program seems to me to be a step backward. Especially when you consider the following:

Trends in Alternative Medicine Use in the United States, 1990-1997
Eisenberg GM, Davis RB, Ettner SL, etal
From: Journal of the American Medical Association
Volume/Edition: 280 (18)
Pages/Time: 1569-1575
Source/Year: November 1998"

OP: http://forums.studentdoctor.net/showpost.php?p=2318810&postcount=16

"In that study (see: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9761802), the findings were 'In children with mild or moderate asthma, the addition of chiropractic spinal manipulation to usual medical care provided no benefit.'"

"From my favorite (Cochrane reviews) on 'Manual Therapy for Asthma':
'From 393 unique citations, 59 full text articles were retrieved and evaluated, which resulted in nine citations to five RCTs (290 patients) suitable for inclusion. Trials could not be pooled statistically because studies that addressed similar interventions used disparate patient groups or outcomes. The methodological quality of one of two trials examining chiropractic manipulation was good and neither trial found significant differences between chiropractic spinal manipulation and a sham manoeuvre on any of the outcomes measured. Quality of the remaining three trials was poor. One small trial compared massage therapy with a relaxation control group and found significant differences in many of the lung function measures obtained. However, this trial had poor reporting characteristics and the data have yet to be confirmed. One small trial compared chest physiotherapy to placebo and one small trial compared footzone therapy to a no treatment control. Neither trial found differences in lung function between groups.'"

OP: http://forums.studentdoctor.net/showpost.php?p=2268005&postcount=8

Here are links to the abstracts: http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=12221360 and http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=7638657.

OP: http://forums.studentdoctor.net/showpost.php?p=2183403&postcount=46

"Chiropractors were included in two types of these studies, those of low back pain, and those looking at workingmans' compensation costs. see: http://www.annals.org/cgi/content-nw/full/127/1/52/T2 Their findings were hardly supportive of chiropractic."

"The study abstract is here: http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=15477432. While the study is interesting for it's size, there are serious design problems. I quote from the journal editor's comments in the same issue.

'The study design does not permit the definite determination of a cause-effect relationship between access to chiropractic and a more budget-effective approach to musculoskeletal care, pointing rather to the coexistence of the 2 phenomena in a managed-care population. Furthermore, the lack of a random element in defining the populations with and without access to chiropractic care may have partly compromised the validity of the results. The favorable health profile of the 'chiropractically insured' is of particular concern. They comprise a younger and healthier population and, thus, are likely to have better outcomes and fewer health expenses. Even though the authors attempt to correct for this discrepancy, it is worrisome to assume the generalizability of the perceived cost-savings to a sicker, older cohort. In addition, the study portrays a population specific to a particular health care plan and within a particular state and, perhaps, not typically representative of other states or of patients who are insured by Medicaid or Medicare. Another generalizability issue arises from the lack of information regarding patient ethnicity, making the extrapolation of the authors' conclusions to minority populations problematic.'"​

OP: http://forums.studentdoctor.net/showpost.php?p=2183516&postcount=47

"The study is here: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9801210 with a follow-up study here: http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=11940622. Now there are two problems with this as far as your argument is concerned. First, this test was not given to first year out chiropractic graduates, so it doesn't say that chiropractors would do any better. Second, it was administered to interns, who still had an average of three to five years of training remaining. The test itself was validated by administration to eight senior orthopedic surgery residents, all of whom passed. So what have we proven? MD/DOs do a residency for a reason. It is an integral part of our training. Big deal. I'd have granted you that without a study."

OP: http://forums.studentdoctor.net/showpost.php?p=2135577&postcount=95

"Now as an (I assume) educated person, what is your opinion/reaction to these studies?"

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

OP: http://forums.studentdoctor.net/showpost.php?p=2139393&postcount=120

"No, what I am referring to is summarized here: http://nccam.nih.gov/health/chiropractic/index.htm#app2

Three systematic reviews that concluded "Overall, the evidence was seen as weak and less than convincing for the effectiveness of chiropractic for back pain. Specifically, the 1996 systematic review reported that there were major quality problems in the studies analyzed; for example, statistics could not be effectively combined because of missing and poor-quality data. The review concludes that the data 'did not provide convincing evidence for the effectiveness of chiropractic.' The 2003 general review states that since the 1996 systematic review, emerging trial data 'have not tended to be encouraging…. The effectiveness of chiropractic spinal manipulation for back pain is thus at best uncertain.' The 2003 meta-analysis found spinal manipulation to be more effective than sham therapy but no more or no less effective than other treatments."

- H

 

[Taus]

can of worms is officially open...keep it civil folks

 

[91z4me]

O.k., I'm an MD, who goes to a DO as his PCP. There is a simple fact you are overlooking (as do most MDs). Since the Flexner report there has, in fact, been very little difference between MDs and DOs. Both traditional medicine and osteopathy were brought into a standardized method of education that insured (to some degree) that all providers were equal in their approach to patients.

And do you know why the DO degree is so closely aligned with that of the MD? Because the Rule of the Artery was disproven. The control center of the human body is the nervous system, correct. So Osteopathy didn't have a proverbial leg to stand on so they were incorporated into traditional allopathic medicine, much as homeopathy was prior to it. The stance of DD Palmer that the Nervous system was the control center turned out to be correct, if you believe the premise behind Chiropractic you must admit this fact. I think you left out a little bit of time between the Flexner Report 1920s and the alignment of Osteopathy with traditional medicine 1960s if I recall correctly.

There is no such standard in chiropractic.

Wrong. There are standards of care within Chiropractic. Specifically there are standards within each state's statue on Chiropractic.

There are "straight" chiropractors who hold dear the principles of Palmer and the belief that nervous system dysfunction holds the key to most health problems. Then there are the "mixers" who agree that there is little scientific basis for most of Palmer's theories, but who feel chiropractic is a useful modality for treatment neuro/muscular/skeletal problems. Then there are the "psuedo-mixers" who hold on to Palmer's theories and try and expand them through "new" and decidedly non-medical practices.

While there is some truth to what you say in division of philosphy and principles within Chiropractic, it doesn't matter. If you find a DC who adjusts the whole spine, not just a super straights doing C1-C2, you will likely get very similar techniques and diagnosis from a large sample pool. The Diversified technique remains the mainstay of the Chiropractic profession. While there are offshoots such as Rienert Specific Diversified technique, Thompson, Gonstead, SOT, AK, and many others the basic premise remains. A malposition of a vertebra may have some effect upon the nerve exiting its lateral vertebral foramen. The type of adjustment given is intended and likely will reposition the vertebra within its 'proper' or ideal position relative to the vertebra above and below, which would reduce the impact of the malposition on the nerve. ANY Chiropractor can tell you that!

These folks are often very "anti-medicine" and truly believe that the "Rosetta Stone" to all of health lay within their grasp.

That is a VERY small minority of the body of Chiropractic and should we judge an entire profession based upon the actions of a few?

These groups infight so much that it is impossible to even define chiropractic care anymore because the care you will recieve will vary so greatly based on which "camp" your practitioner comes from.

ERRRR, Wrongo! Chiropractic care is defined as adjustments intended to improve the structural postion of the vertebral column and related structures, sacrum/occiput. That is Chiropractic in a nutshell. What is said beyond that is related to philosphy and is quite debatable. Just as there is quite a bit of debate between certain specialties within traditional medicine.

Additionally, te training for chiropractors is nowhere close to that which physicians get. The closest physician, in terms of practice, to a chiropractor is a physiatrist. The physiatrist is required to have four years of medical school, 1 year of internship, and three years of residency training. Now, chiropractors will try and tell you that they somehow cram 5 years of training into 3 years. This is because they use the federal financial aid rules to define a year (1 year = 2 semesters). By this math, a physiatrist has 11 1/2 "years" of training.

Have you attended any classes at a Chiropractic school? Have you taken a look at their curriculum? What about the national boards? State boards? Well then how do you know what the heck they teach at the schools or what the qualificiations are? Oh wait it is time, total hours, that you are talking about right? Ok how about 1 school in particular say your alma mater compared to 1 that I found with a quick google search. http://www.logan.edu/pages/prostudent_doc.asp

In practice the Logan College program provides students 4,965 hours in numerous areas relevant to the successful practice of a chiropractic physician. 800 hours are dedicated to hands-on adjusting courses.In practice the Logan College program provides students 4,965 hours in numerous areas relevant to the successful practice of a chiropractic physician. 800 hours are dedicated to hands-on adjusting courses.

Also, understand that, while they are properly referred to as "doctors" in practice, the DC is not generally recognized as an academic degree. There are many teaching hospitals where a DC would not be referred to as "doctor" (there are policies stipulating who can and can't be called "doctor" to prevent confusing patients and staff). There are no institutions of higher education, other than chiropractic colleges, where a DC is an acceptable degree for admission to academic faculty. (And before everyone starts screaming about T. Yochum at Colorado, he lectures there, he is not a professor, he is not on tenure track, and he does not hold academic rank. Nurses, paramedics, PTs and RTs hold similar positions at many schools. That doesn't make them faculty).

Additionally, chiropractic is not supported by the current literature for any condition other than idiopathic LBP. For that condition, studies have demonstrated that chiropractic is "as good as" but not better than traditional medical treatment. You should keep in mind that both chiropractic and traditional medicine are statistically only slightly better than placebo in those cases, so there is not a strong arguement for either. Read this for a bit more skeptical take on chiropractic education: http://quackfiles.blogspot.com/2005/02/why-i-left-chiropractic.html

There are several papers out that demonstrate how ineffectively chiropractors are prepared for practice in primary care, the best of which is here: http://www.ncbi.nlm.nih.gov/entrez/..._uids=15965408&query_hl=1&itool=pubmed_docsum

Do you know why Chiropractors wanted to be included as PCPs? So that insurance would allow visits without refferals from MDs and DOs. It had nothing to do with diagnosing above and beyond the levels of other healthcare providers. Do you honestly think that is what it was about? You might find the same thing about PTs who are seeking PCP status.

And dude quoting some place called quackfiles, which appears to just be a personal blog? Get real! You and I don't know nor could we prove it that actually happened or if someone just made it up.

BTW - the practicing orthopods ALL passed the test and were used as controls!

- H

That is great for them. I won't comment on the rest of that study because well I saw it posted in another thread and I don't feel like reading it, call me lazy.

 

[91z4me]

<P>I had written up a reply to FoughtFyr's last post but for some reason the board made me log in again and I lost it.&nbsp; I will resume with it later, I must go for now.&nbsp; I will return if this thread remains hospitible and professional.</P>

 

[FoughtFyr]

And do you know why the DO degree is so closely aligned with that of the MD? Because the Rule of the Artery was disproven. The control center of the human body is the nervous system, correct. So Osteopathy didn't have a proverbial leg to stand on so they were incorporated into traditional allopathic medicine, much as homeopathy was prior to it. The stance of DD Palmer that the Nervous system was the control center turned out to be correct, if you believe the premise behind Chiropractic you must admit this fact. I think you left out a little bit of time between the Flexner Report 1920s and the alignment of Osteopathy with traditional medicine 1960s if I recall correctly.

No, I didn't leave anything out. Osteopathy was included in the standardization following the Flexner report.

I don't believe the premise of chiropractic at all. There is far more to the body than nerves.

Wrong. There are standards of care within Chiropractic. Specifically there are standards within each state's statue on Chiropractic.

YAWN. Prove that chiropractic works, for any condition, before you start the argument that such a treatment is standardized.

While there is some truth to what you say in division of philosphy and principles within Chiropractic, it doesn't matter.

Sure it does. In order to accurately assess a therapy, it's definition must be understood and universal.

If you find a DC who adjusts the whole spine, not just a super straights doing C1-C2, you will likely get very similar techniques and diagnosis from a large sample pool.

But does the public understand the difference?

The Diversified technique remains the mainstay of the Chiropractic profession. While there are offshoots such as Rienert Specific Diversified technique, Thompson, Gonstead, SOT, AK, and many others the basic premise remains.

So I guess all of the chiropractic ads touting one method over the other are wrong?

A malposition of a vertebra may have some effect upon the nerve exiting its lateral vertebral foramen. The type of adjustment given is intended and likely will reposition the vertebra within its 'proper' or ideal position relative to the vertebra above and below, which would reduce the impact of the malposition on the nerve. ANY Chiropractor can tell you that!

And any scientist will tell you that theory is unproven bovine scatology...

ERRRR, Wrongo! Chiropractic care is defined as adjustments intended to improve the structural postion of the vertebral column and related structures, sacrum/occiput. That is Chiropractic in a nutshell. What is said beyond that is related to philosphy and is quite debatable. Just as there is quite a bit of debate between certain specialties within traditional medicine.

Yes but the debates in medicine are fueled by the research driving the practice. No such evidence exists for chiropractic.

Have you attended any classes at a Chiropractic school? Have you taken a look at their curriculum? What about the national boards? State boards? Well then how do you know what the heck they teach at the schools or what the qualificiations are? Oh wait it is time, total hours, that you are talking about right? Ok how about 1 school in particular say your alma mater compared to 1 that I found with a quick google search. http://www.logan.edu/pages/prostudent_doc.asp

"In practice the Logan College program provides students 4,965 hours in numerous areas relevant to the successful practice of a chiropractic physician. 800 hours are dedicated to hands-on adjusting courses.In practice the Logan College program provides students 4,965 hours in numerous areas relevant to the successful practice of a chiropractic physician. 800 hours are dedicated to hands-on adjusting courses."​

Wow. 800 WHOLE HOURS. So the rough equivalent of 10 weeks of clerkship or residency. Yeah, that almost compares. But really, let's look at the education differences shall we?

According to the CCE USA's website, as well as those of several state chiropractic associations, chiropractors are required to have 4200 "instructional hours" of training. This includes classroom time as well as clinical time. It is a sizable load for three calendar years. MDs do not have a specific requirement, but according to an article (see: http://jama.ama-assn.org/cgi/content/full/292/9/1025 ) we spend, on average 1600 so so classroom hours in the first two years. Since that is the only published number - chiropractic students are "better trained".

Except for the pesky problem of the 3rd and 4th year. While there are no nationally published numbers, there are growing complaints that 3rd year medical students should not be exempt from the 80 hour work week rules that govern residents. The implication being that 3rd year clerks work more than 80 hours weekly. But without data, I can't address that, except through personal experience. So let's look at my third year:

48 week program
Family practice - longitudinal across the year, one day per week, 8 hours a day, four weeks off, no call - total time: 352 hours
Surgery - 12 week clerkship, 5 days a week (plus FP), average work day 12 hours, 6 overnight calls, 1 weekend call - total time: 720 hours (plus 96 hours of call)
Internal Medicine - 12 week clerkship, 5 days per week (plus FP), average work day 11 hours, 14 call nights until midnight, 2 weekend call - total time: 660 hours (plus ~ 136 hours of call)
Psychiatry - 8 week clerkship, 4.5 days per week (plus FP), average work day 8 hours, call from home so I won't even count it - total time: 288 hours
Pediatrics - 8 week clerkship, 4 days per week (plus FP), average work day 10 hours, 5 call nights until midnight, 2 17 hour weekend calls - total time: 320 hours (plus 74 hours of call)
OB/GYN - 8 week clerkship, 4.5 days per week (plus FP), average work day 10 hours, 5 overnight calls, 2 weekend calls - total time: 360 hours (plus 118 hours of call)

All told, my third year was roughly 2700 hours plus ~425 hours of call in 48 weeks (or ~65 hrs/wk) and I spent most of that year being in the hospital or clinic 6 (sometimes 7) days per week, between my FP day and the wards. The schedule for fourth years vary by individual student, because of electives. Call volume is far reduced as is ward time. My best guesstimate is roughly 1800 hours plus 200 of call. So, the third and fourth years together (~5125 hours) are more than the hours needed for a DC (at least in my alma mater's cirriculum). This is to say nothing of the ~1600 classroom hours in years one and two. And, of course, leaving out residency entirely.

I will agree with you however, that chiropractic college may be roughly equal to years one and two of medical school (but I would still like to see the breakdown of the 4200 hours).

And please remember that does not account for residency at all, nor does it account for the difference in acuity of the patients seen by MD/DO students in the wards and those seen by chiropractic students in their clinics.

Do you know why Chiropractors wanted to be included as PCPs? So that insurance would allow visits without refferals from MDs and DOs. It had nothing to do with diagnosing above and beyond the levels of other healthcare providers. Do you honestly think that is what it was about? You might find the same thing about PTs who are seeking PCP status.

Neither PTs nor DCs should be able to see patients without referrals. But if one has to be allowed I would far prefer the PT who is at least trained within the medical model.

That is great for them. I won't comment on the rest of that study because well I saw it posted in another thread and I don't feel like reading it, call me lazy.

No, I won't call you lazy, but I will point out that you merely offer anecdote and dogma as opposed to scientific evidence.

- H

 

[tdkneo]

anybody ever consider to be a Dc instead of Do?

NO!!!

 

[NRAI2001]

Who gives a dam.........time to unsubscribe.

 

[91z4me]

FoughtFyr, you know what I don't think I am going to get into a debate with you over this or anything else. I can see that you will not change and that you have your beliefs and that is fine. But you should understand that not EVERYTHING is medical and not everything needs to be within the medical model.

That being said I would avoid bashing the profession of Chiropractic as it is against the rules here. I will be around to talk to those who want to find out about Chiropractic.

Edit: The flexner report was published in 1910 and, according to wikipedia, the osteopathy profession became aligned with MDs around 1969.

 

[FoughtFyr]

FoughtFyr, you know what I don't think I am going to get into a debate with you over this or anything else. I can see that you will not change and that you have your beliefs and that is fine. But you should understand that not EVERYTHING is medical and not everything needs to be within the medical model.

That being said I would avoid bashing the profession of Chiropractic as it is against the rules here. I will be around to talk to those who want to find out about Chiropractic.

I am not "bashing" chiropractic. I am simply asking that you provide the scientific basis behind your claims. Any new drug or procedure in medicine would need to be similarly validated. There are quality studies supporting accupuncture. I am not against all forms of alternative medicine, just the invalid ones.

- H

 

[FoughtFyr]

Edit: The flexner report was published in 1910 and, according to wikipedia, the osteopathy profession became aligned with MDs around 1969.

Since you like wikipedia so much (from: http://en.wikipedia.org/wiki/Flexner_Report).

"Impact on osteopathic medicine

When Flexner researched his report, allopathic medicine faced vigorous competition from several quarters, including osteopathic medicine and homeopathic medicine. Flexner clearly doubted the scientific validity of all forms of medicine other than the allopathic, deeming any approach to medicine that did not employ drugs to help cure the patient as tantamount to quackery and charlatanism. Medical schools that offered courses in bioelectric medicine, eclectic medicine, homeopathy, or "eastern medicine," for example, were told either to drop these courses from their curriculum or lose their accreditation and underwriting support. A few schools resisted for a time, but eventually all complied with the Report or shut their doors.

When Flexner researched his Report, the USA contained a number of medical schools training osteopathic and homeopathic practitioners. Because doctors of osteopathy (D.O.s) often had practices whose scope was similar to that of M.D.s, Flexner insisted that the training of DOs be held to the same standard as that of MDs. Osteopathic medical schools had fought hard over the years for their independence from allopathic medicine, and resented being included in Flexner's report, which concluded that the standards of osteopathic schools were in fact substantially lower. As a result of the Report, the American Medical Association (AMA) expected all osteopathic medical schools to close. Instead, through a series of internal revolutions, the American Osteopathic Association (AOA) brought a number of its schools into compliance with Flexner's recommendations.

Before the Flexner report, osteopathic and allopathic training had little in common. As a result of the Flexner report, American osteopathic medical schools today teach evidence-based, scientific medicine. The curricula of osteopathic and allopathic medical schools differ only minimally, the chief difference being the additional instruction in osteopathic schools of manipulative medicine. This dramatic convergence of osteopathic and allopathic training demonstrates the sweeping effect the Flexner report had, not only in the closure of inadequate schools, but also in the standardization of the curricula of surviving schools."​

On the other hand, I've actually read the original report.

- H

 

[91z4me]

On the other hand, I've actually read the original report.

- H

Perhaps instead of making assumptions you should read further.
http://en.wikipedia.org/wiki/Osteopathy
"With its origins in the late 1800's, osteopathy was initially a variant of the contemporary Western medical approach, and became integrated with mainstream medicine in 1969."

Now if you want specific research on a particular treatment with chiropractic adjustments I suggest you contact one of the national or international Chiropractic associations. I am not a chiropractor. I am not a member of one of those organizations, nor do I have access to research studies or any professional journals. Being that as it may I don't think the scientific debate over chiropractic reasearch was the point of this thread. Nor was it in many of the other threads I have seen you post the same things in. Being that as it may, many of the reports you posted do not conclusively show the ineffectiveness of chiropractic. When I have time I can highlight those points which make this clear since you don't see them due to your preconcieved negative notions about chiropractic.

 

[FoughtFyr]

Perhaps instead of making assumptions you should read further.
http://en.wikipedia.org/wiki/Osteopathy
"With its origins in the late 1800's, osteopathy was initially a variant of the contemporary Western medical approach, and became integrated with mainstream medicine in 1969."

A wikipedia entry on Osteopathy does not change the findings of the Flexner report. Nor does it "prove" your point that Osteopathic training wasn't contained in the report. It was - that is a fact.

Now if you want specific research on a particular treatment with chiropractic adjustments I suggest you contact one of the national or international Chiropractic associations.

Actually no organization can provide proof of chiropractic's efficacy. There isn't any. The least biased organization toward chiropractic is the National Center for Complementary and Alternative Medicine (NCCAM). NCCAM is the Federal Government's lead agency for scientific research on complementary and alternative medicine (CAM). They are 1 of the 27 institutes and centers that make up the National Institutes of Health (NIH) within the U.S. Department of Health and Human Services.

Their findings on chiropractic - "research studies of chiropractic treatment for low-back pain have been of uneven quality and insufficient to allow firm conclusions. Nonetheless, the overall sense of the data is that for low-back pain, chiropractic treatment and conventional medical treatments are about equally helpful. It is harder to draw conclusions about the relative value of chiropractic for other clinical conditions." That is as good as it gets.

I am not a chiropractor. I am not a member of one of those organizations, nor do I have access to research studies or any professional journals.

Well may I ask who you are (as in profession, training etc.)? Your profile lists you as an "other health professions student". What kind of institution are you at that you do not have access to scientific publications?

Being that as it may I don't think the scientific debate over chiropractic reasearch was the point of this thread. Nor was it in many of the other threads I have seen you post the same things in. Being that as it may, many of the reports you posted do not conclusively show the ineffectiveness of chiropractic. When I have time I can highlight those points which make this clear since you don't see them due to your preconcieved negative notions about chiropractic.

You invite scientific debate when you post on the validity of the chiropractic. But I look forward to your interpretation of the studies. And my notions about chiropractic are not "preconcieved". Time did not start when you joined this forum. I have extensively researched chiropractic including spending a day at Palmer and meeting with several faculty there. My opinion of chiropractic is based on personal experiences and a careful examination of the available literature, same as my opinion of most things in healthcare.

- H

 

[hb2998]

Why not a DO vs DPM post?
Why not a DO vs OT post?
Why not a DO vs PT post? (PT is a great field!)

If DO=MD, and DO is being put up against DC, does that mean a DC=MD?

This reminds me of a gathering I was at, the conversation went like this:

Person1: Hello, I'm DR. [LastName],
Person2: I'm John, a pleasure to meet a colleague, [Shake Hands]
Person3: John specializes in Orthopedic Surgery, what field do you specialize in?
Person1: [Turns Red] - Chiropractic.

I'm not trying to be rude, but I have strong beliefs about the field of medicine and will stand by them. I'm tired of fake treatments which seem to work due to the placebo effect. I have a friend who is a DC/JD, he explained to me what they taught him after the teacher would turn off the voice recorder in Chiropractic school.

If you claim that the job chiropractics do is beneficial, I agree with you to some extent (for why I don't agree 100% please see the stories on FAACT, and hundreds of people left disabled from chiropractic manipulations), however, I don't see why people won't become an OT or PT instead of DC. Yes OTs and PTs don't get the title "Doctor" unless they get a PhD or DPT, true its much harder to get into, yes the pay is less ..... but its honest work and you are a respectable member of the allied health community.

If you are thinking of becoming a DC, please keep in mind that many of your colleagues do and will engage in unethical activities, some do get jail sentences (family acquaintance), and yes naturally the field does have a really bad name. You are going to study, why not study something thats worth it, respected and beneficial to society.

Please don't consider this post a flame, its just my opinion. I am very displeased to have anybody even ponder DC and MD/DO as even nearly the same.

 

[Gentle_Touch]

DCs has its own philosophy, you cant compare it to anything, maybe an ND. Truth story, an MD (Family Practice) has to refer a pt to chiropractic, because this patient show no improvement with the prescribed drugs. The patient, however, did respond well with the chiropractor Tx. *MD/DO Physicians are not God, there are solely trained to prescribe drugs and surgeries, not alternative meds. So when we seek for healthcare keep an open-minded, it's all about well-being.

*Please no thrashin' just a thought.

 

[DropkickMurphy]

DCs has its own philosophy, you cant compare it to anything, maybe an ND.

That's a good thing to want to be compared to.

 

[FoughtFyr]

DCs has its own philosophy, you cant compare it to anything, maybe an ND.

That "philosophy" is unproven.

Truth story, an MD (Family Practice) has to refer a pt to chiropractic, because this patient show no improvement with the prescribed drugs.{emphasis added}

A MD or DO in any practice (family medicine or otherwise) is under NO obligation to EVER refer a patient to a chiropractor. In fact, in the states with joint and several liability, they may be held liable for such a referral as it is far afield of the standard of care.

The patient, however, did respond well with the chiropractor Tx.

So they had a self-limited disorder. Besiding the fact that this bland description doesn't even rise to the level of anecdote, the plural of anecdote is not fact, contrary to popular belief.

*MD/DO Physicians are not God, there are solely trained to prescribe drugs and surgeries, not alternative meds. So when we seek for healthcare keep an open-minded, it's all about well-being.

*Please no thrashin' just a thought.

Wrong. MDs and DOs are trained in medicine and surgery. I will prescribe niacin, asprin, heck even thiamine when medically indicated. I am not God, I am a scientist and act accordingly. Chiropractors can't act as scientists unless they are practicing a different profession - there is simply no scientifically demonstrable benefit to chiropractic.

- H

 

[Gentle_Touch]

A MD or DO in any practice (family medicine or otherwise) is under NO obligation to EVER refer a patient to a chiropractor. In fact, in the states with joint and several liability, they may be held liable for such a referral as it is far afield of the standard of care.
Can we get a citation? What about states that dont.. no problem. Physicians are ALWAYS the primary caregiver, (this is a dominant Physicians' forum & dont even have chiropractic topic listed) but sometimes it is better for other alternative tx methods, ie)acupunture, chiro etc. It's referrable, some insurance requires prior auth from PCP, physicians are allow to refer to chiro. I am not talking about obiligation, nobody has any obiligations if he/she chose not to. Later on in your career..when you exposed to more conditions, you probably wil change your opinion. Right now, you probably just fresh out of college, med school, or maybe just a few year practicing.


there is simply no scientifically demonstrable benefit to chiropractic. Simple. Depends who done the studies.

 

[FoughtFyr]

Can we get a citation? What about states that dont.. no problem. Physicians are ALWAYS the primary caregiver, (this is a dominant Physicians' forum & dont even have chiropractic topic listed) but sometimes it is better for other alternative tx methods, ie)acupunture, chiro etc.

There is no citation needed. Let's look at this simply - chiropractors and alternative medicine providers are defacto outside the medical profession. Alternative treatment is rarely (if ever) proven to be a better alternative. Some studies indicate accupuncture might have a role as a complementary therapy. But chiropractic, no.

It's referrable, some insurance requires prior auth from PCP, physicians are allow to refer to chiro.

Ahh, now we are talking "allowed to" by insurance company rules. A totally different supposition than you posted.

I am not talking about obiligation, nobody has any obiligations if he/she chose not to.

Actually MD/DOs are obligated to make appropriate referrals when a patient's condition calls for it. For example, a family medicine physician who diagnoses a ST elevation MI is obligated (under the standard of care) to refer the patient for treatment.

Later on in your career..when you exposed to more conditions, you probably wil change your opinion. Right now, you probably just fresh out of college, med school, or maybe just a few year practicing.

Umm, I'm a senior resident in emergency medicine. I have seen enough patients either hurt or defrauded by sCAM providers to give me legitimate cause for concern. However, should reasonable studies prove a modality, I will consider it.

there is simply no scientifically demonstrable benefit to chiropractic. Simple. Depends who done the studies.

Wrong again. There are NO studies accepted by the scientific community in favor of chiropractic. Once again, the least biased scientific organization toward chiropractic is the National Center for Complementary and Alternative Medicine (NCCAM). NCCAM is the Federal Government's lead agency for scientific research on complementary and alternative medicine (CAM). They are 1 of the 27 institutes and centers that make up the National Institutes of Health (NIH) within the U.S. Department of Health and Human Services.

Their findings on chiropractic - "research studies of chiropractic treatment for low-back pain have been of uneven quality and insufficient to allow firm conclusions. Nonetheless, the overall sense of the data is that for low-back pain, chiropractic treatment and conventional medical treatments are about equally helpful. It is harder to draw conclusions about the relative value of chiropractic for other clinical conditions." That is as good as it gets.

It isn't a proven modality. Regardless of what you think. Perhaps when you are "Later on in your career..when you exposed to more conditions, you probably wil change your opinion."

- H

 

[91z4me]

Well may I ask who you are (as in profession, training etc.)? Your profile lists you as an "other health professions student". What kind of institution are you at that you do not have access to scientific publications?

Since you asked so nicely I am a student at a leading academic Chiropractic college in the US. I am in my second Trimester. While I may have access to research articles I do not have the time to research articles for you nor do I have the ambition. I did post a few studies I found on pubmed.gov in another thread for your review which show correlation between the spinal column and viceral tissue, specifically one involving heart attack patients and paravertebral palpational tenderness.

And my notions about chiropractic are not "preconcieved". Time did not start when you joined this forum. I have extensively researched chiropractic including spending a day at Palmer and meeting with several faculty there. My opinion of chiropractic is based on personal experiences and a careful examination of the available literature, same as my opinion of most things in healthcare.

So 1 day and your own personal research qualifies you as an authority? I don't quite think so. You are totally entitled to your opinion and it is your right as a citizen of the US, which I completely support. I just seemed to notice that in each thread about chiropractic, that I conducted after my search, you seemed to respond quite negatively. Even if the question posed was not involving the scientific or medical relavancy of Chiropractic. Also you seem to enjoy debate, and if I may say are quite good at it. But as I pointed out earlier I did see some questionable conclusions being drawn and if time allows I will offer my view of them in my own time.

 

[FoughtFyr]

Since you asked so nicely I am a student at a leading academic Chiropractic college in the US. I am in my second Trimester. While I may have access to research articles I do not have the time to research articles for you nor do I have the ambition.

Actually, you are not providing the research "for me". You are providing it for yourself. The basis of science is that nothing is to be considered "fact" until proven. If you are here asserting that chiropractic is a valid modality, prove it. And by what measure are you defining "leading academic Chiropractic college". I don't think any chiropractic collages are widely accepted (outside of chiropractic) as "academic centers".

I did post a few studies I found on pubmed.gov in another thread for your review which show correlation between the spinal column and viceral tissue, specifically one involving heart attack patients and paravertebral palpational tenderness.

Thanks, I'll look at it. But in my opinion (as a senior EM resident who deals with myocardial infarctions daily and who has lectured nationally on the topic of emergency cardiology) chiropractic has absolutely no business anywhere near an MI patient.

So 1 day and your own personal research qualifies you as an authority? I don't quite think so.

Actually an undergraduate degree in health policy, an MPH, an MD and extensive research on the topic makes me an authority. But none of that matters, I'm arguing from the status quo. Your supposition of change requires the weight of authority and evidence.

- H

 

[EctopicFetus]

Sweet topic.. LOL.. I was always a skeptical about chiros... then i met one in a semi-social environment... now I am 100% with FF..

Basically it is a scam IMO. There is no evidence for the therapy and in the end they sometimes bring me business.. (as a non senior EM resident).

I have seen 2 strokes from c spine manipulation... no fun..

 

[91z4me]

Actually, you are not providing the research "for me". You are providing it for yourself. The basis of science is that nothing is to be considered "fact" until proven. If you are here asserting that chiropractic is a valid modality, prove it. And by what measure are you defining "leading academic Chiropractic college". I don't think any chiropractic collages are widely accepted (outside of chiropractic) as "academic centers".

The college I attend does hundreds of research studies each year with many published articles each year and consults many local and national companies on workplace ergonomics as well as in other ways. It also scores consistently with the highest scores on the National Boards amongst all the other Chiro schools. That being said I don't think any data has been compiled as to the level of education of Chiro students vs MD or DO, on the academic level. So if we are presenting facts you would have to stipulate that this is just your personal opinion.

Thanks, I'll look at it. But in my opinion (as a senior EM resident who deals with myocardial infarctions daily and who has lectured nationally on the topic of emergency cardiology) chiropractic has absolutely no business anywhere near an MI patient.

At the time of MI I don't either, unless it is to provide first aid or use an AED. Though I have no experience with MI (save a grandfather I lost to one when I was 11), nor do I have exposure to any of the mechanisms behind or prevalent amongst those who suffer one. The article's indication, as I read it, is that paravertebral muscular changes may be an indicator prior to an MI occuring. And, infering a little more, that by identifying this indicator prevention may be possible.

Actually an undergraduate degree in health policy, an MPH, an MD and extensive research on the topic makes me an authority. But none of that matters, I'm arguing from the status quo. Your supposition of change requires the weight of authority and evidence.

- H

The status quo isn't going to be changed by me. The RESEARCH is going to lead to change. Unless I end up in research, which is unlikely given my planned career path, I won't drive the change. I will support it with funds when the time comes. As far as you arguing that as the status quo Chiros are quacks with no research showing any clinical sigifigance. I don't think so. IF as you suggest Chiros have no clinical relevancy and they don't do anything more than placebo then why are they still around and why have they gained main market acceptance? Why did the Supreme court find that the AMA and its committee on quackery were violating anti-trust regulations? I mean if the evidence is overwhelmingly against Chiropractic and spinal manipluation/adjustment, then WHY is it that the supreme court didn't find in favor of the AMA and other litigates?

I mean come on if ALL the data shows that Chiro is bogus then why is it still around? It is because not ALL of the data shows that, I am sure you will contend with this but even your extensive research shows that there are demostrable benefits. The data which shows benefit is out there, and new research is done all the time. I personally believe that research will only strengthen the position of Chiropractic and that is why I am in favor of it. If your position is that research condemns Chiropractic then I think you would be in favor of it as well, correct?

So while, for the time being, the issue between us, a future DC and an MD, is not settled I think we are both awaiting the research which will either strengthen or weaken our position. Interestingly enough the only way that either will be proven is with the same thing, research.

 

[FoughtFyr]

The college I attend does hundreds of research studies each year with many published articles each year and consults many local and national companies on workplace ergonomics as well as in other ways. It also scores consistently with the highest scores on the National Boards amongst all the other Chiro schools.

Good for you. You have the best scores among chiropractors. That and $5 will get good a decent mocha at Starbucks.

That being said I don't think any data has been compiled as to the level of education of Chiro students vs MD or DO, on the academic level.

There is no comparison. Time, depth, scope - none are even close to equivalent. The entrance requirements are far less for chiropractic. The time in training is far less. The acuity of the patients seen is far less. The number of patients are far less.

So if we are presenting facts you would have to stipulate that this is just your personal opinion.

Actually I said "I don't think any chiropractic collages are widely accepted (outside of chiropractic) as "academic centers"." {emphasis added} Here is what you need to understand - outside of chiropractic, the DC means nothing. MDs are hired to teach at many institutions outside of medical education. DCs (without additional qualifications) are not. Thus my opinion that chiropractic colleges are not generally considered academic centers. But hey, since you guys score so well it must be.

At the time of MI I don't either, unless it is to provide first aid or use an AED. Though I have no experience with MI (save a grandfather I lost to one when I was 11), nor do I have exposure to any of the mechanisms behind or prevalent amongst those who suffer one.

But you feel qualified to become a primary care provider? You do realize that EVERY licensed physician has done an intern year and has treated these patients. EVERY licensed physician has rotated through internal medicine, surgery, family medicine, psychiatry, and OB/GYN as medical students and most have rotated in an emergency department.

The article's indication, as I read it, is that paravertebral muscular changes may be an indicator prior to an MI occuring. And, infering a little more, that by identifying this indicator prevention may be possible.

Actually, it doesn't even come close to that. It suggests these changes exist after an MI. And even that is nebulous and subjective. The article has absolutely nothing to do with chiropractic by the way. It is an osteopathic paper.

The status quo isn't going to be changed by me. The RESEARCH is going to lead to change.

I'm glad you know the outcome of the research already. It is always easier that way. It is too bad that the NIH center on alternative medicine doesn't share your optimism.

Unless I end up in research, which is unlikely given my planned career path, I won't drive the change. I will support it with funds when the time comes. As far as you arguing that as the status quo Chiros are quacks with no research showing any clinical sigifigance. I don't think so.

Then post it here! And notify Cochrane and the NCCAM - they would love to know! Hey, if there is good data out there I'd happily co-author the Cochrane review with you.

IF as you suggest Chiros have no clinical relevancy and they don't do anything more than placebo then why are they still around and why have they gained main market acceptance?

I never said they weren't good marketers! Hey, taking credit for self-limited diseases has been a lucrative business for years! Kevin Trudeau has nothing on you.

Why did the Supreme court find that the AMA and its committee on quackery were violating anti-trust regulations? I mean if the evidence is overwhelmingly against Chiropractic and spinal manipluation/adjustment, then WHY is it that the supreme court didn't find in favor of the AMA and other litigates?

Actually, you need to read the case. From: Wilk v. American Medical Ass'n, 671 F. Supp. 1465, N.D. Ill. 1987

"The plaintiffs clearly want more from the court. They want a judicial pronouncement that chiropractic is a valid, efficacious, even scientific health care service. I believe that the answer to that question can only be provided by a well designed, controlled, scientific study... No such study has ever been done. In the absence of such a study, the court is left to decide the issue on the basis of largely anecdotal evidence. I decline to pronounce chiropractic valid or invalid on anecdotal evidence."

and

"The study of how the five original named plaintiffs diagnosed and actually treated patients with common symptoms was particularly impressive. This study demonstrated that the plaintiffs do not use common methods in treating common symptoms and that the treatment of patients appears to be undertaken on an ad hoc rather than on a scientific basis. And there was evidence of the use of cranial adjustments to cure cerebral palsy and other equally alarming practices by some chiropractors."​

The court found that the AMA referred to chiropractic as a "competitor" in many internal documents. Moving to restrain their trade was a violation of the anti-trust act. That doesn't mean that chiropractic is valid. It means that "conspiring" amongst businessmen to eliminate a common competitor is illegal.

I mean come on if ALL the data shows that Chiro is bogus then why is it still around? It is because not ALL of the data shows that, I am sure you will contend with this but even your extensive research shows that there are demostrable benefits.

No, I've yet to see such a study. Neither has the NIH or any widely accepted EBM group.

The data which shows benefit is out there, and new research is done all the time. I personally believe that research will only strengthen the position of Chiropractic and that is why I am in favor of it. If your position is that research condemns Chiropractic then I think you would be in favor of it as well, correct?

I am in favor of research, but I'm not sure that we (through the VA and medicare) should continue to pay for this unproven methodology. If it becomes proven, the issue could be revisited.

- H

 

[chirogomed]

actually - anyone can "do" drugs...you know nothing about chiropractic obviously...do you actually think that the only way to 'help' people is to prescribe a drug. maybe you need to take a class in the history of medicine; for chiropractic and medinice don't date back to Still or Palmer for that matter...it dates back to Socrates...and my friend Socrates adjusted his patients. i am not slapping the allopathic field in the face...because i believe and respect the allopathic practices' contibutions to healthcare...no i am slapping you in the face and your ignorance...are you that niave to think that some medical doctors aren't quacks either...sheesh...you might have the brains to get into med school...by the way so do i...but based on your 'social apptitude' i wonder if you have what it takes to actually be empathetic of your patient and care about what might be best for them...so when you drop your scalpal on the cutting room floor and tweak a nerve don't come to one of us and ask for a little help - idiot!
yours truely - a future dc

 

[da8s0859q]

actually - anyone can "do" drugs...you know nothing about chiropractic obviously...do you actually think that the only way to 'help' people is to prescribe a drug. maybe you need to take a class in the history of medicine; for chiropractic and medinice don't date back to Still or Palmer for that matter...it dates back to Socrates...and my friend Socrates adjusted his patients. i am not slapping the allopathic field in the face...because i believe and respect the allopathic practices' contibutions to healthcare...no i am slapping you in the face and your ignorance...are you that niave to think that some medical doctors aren't quacks either...sheesh...you might have the brains to get into med school...by the way so do i...but based on your 'social apptitude' i wonder if you have what it takes to actually be empathetic of your patient and care about what might be best for them...so when you drop your scalpal on the cutting room floor and tweak a nerve don't come to one of us and ask for a little help - idiot!
yours truely - a future dc

ohhhhkay then.

 

[t-funk]

I've had several friends who went to chiropractor school. My cousin is married to a chiropractor. They're in their mid-twenties, she stays home with two kids, and they have just built their dream house out in the country. The profession has definately given them a great lifestyle.

However, I personally have great disdain for chiropractors. My SO injured his back at work 1 1/2 years ago, had a fractured vertebrae and a torn disc (Of course, the torn disc was not visible from mere X-rays). The chiropractor told him that he could have him in, and I quote, "100% health" in 3 weeks and lifting boulders again if he went in to get adjusted everyday for those 3 weeks. (His office was professional and beautiful with gently running water everywhere, etc.) He touted several times that he was just as educated as an MD. Anyway he ended up telling workman's comp that he could heal him in 3 weeks also, causing us to have to get a lawyer which was the last thing in the world we wanted to do. Long story short, we mentioned the lawyer and he released my SO to the neurosurgeon. He went on the entire time as he was signing the release about how he had been forced to release 4 people that week to neurosurgeons and something to the effect of how his techniques were just as good as a neurosurgeon's.

Anyway, I know lots of people who love their chiropractors, I would just be very careful about ever entering this field and I really don't see why it's necessary to call people idiots bc of their personal opinions.

 

[DocBR]

actually - anyone can "do" drugs...you know nothing about chiropractic obviously...do you actually think that the only way to 'help' people is to prescribe a drug. maybe you need to take a class in the history of medicine; for chiropractic and medinice don't date back to Still or Palmer for that matter...it dates back to Socrates...and my friend Socrates adjusted his patients. i am not slapping the allopathic field in the face...because i believe and respect the allopathic practices' contibutions to healthcare...no i am slapping you in the face and your ignorance...are you that niave to think that some medical doctors aren't quacks either...sheesh...you might have the brains to get into med school...by the way so do i...but based on your 'social apptitude' i wonder if you have what it takes to actually be empathetic of your patient and care about what might be best for them...so when you drop your scalpal on the cutting room floor and tweak a nerve don't come to one of us and ask for a little help - idiot!
yours truely - a future dc

I have been an avid observer of this form and have thus far stayed out of the debate, but I have to take issue with this.

I am not a MD/DO (not yet, atleast) or a DC. But, I went to a DC for 4 months who promised all sorts of things (and I think he genuinely believed in his practice - to the extent that when my insurance stopped paying, he allowed me to float on the 15$ copay for the remaining 10+ visits).

Anyway, I really liked the guy and when my "adjustment series" was complete, I stopped seeing him. A year later, I herniated a disk between L4-L5 and was in an incredible amount of pain. I went to my PCP first, who sent me to physical therapy (which did not help at all). Then I decided to give the DC a shot who said he could help with the pain, and I should trust him. He began his adjustment and I went home in more pain than when I first went to him. The next day I told him this and said I am not sure I want to continue, and he reassured me that it was the kind of pain that "sometimes gets worse before it can get better" He began to do the adjustment again and did something that hurt so badly I leapt off the bed (with him on top of me). He had irritated the nerve so severely that every time I placed my foot on the ground as I walked, incredibly sharp and intense pain would shoot down my leg. Occasionally, it would be so intense that my leg would just give out and I would nearly fall.

Needless to say, I was done with him. I returned to my PCP who sent me home with some muscle relaxers, endocet and the phone number for a pain management specialist. Kenalog injections to reduce the inflammation, time for the injury to heal, and acupuncture to help with the pain have since cleared up my back problems.

So here is where I take issue with the chiropractor.... First) I was telling him his treatment was causing me pain and I was unsure about continuing and that did not bother him enough to stop (shame on me for listening to him over my own body).

Second) every other health practitioner involved (Physical Therapist, Pain Management Doc and Primary Doc) is in agreement that the DC should not have attempted to treat me after the injury, much less after I complained about the pain he had already caused. In fact, the pain management doc said that without regard to skill of the DC, the resistance that a normal person would offer to a large man forcing your vertebra into alignment would irritate the nerve and be deleterious to the condition.

Thinking back on that now, I realize the DC was full of crap and did not respect the limits of his profession. Infact, I remember I went in one time when I had the flu and he tried to send me home with Bovine Colostrum and colloidal silver (which I did not accept).

Anyway, that was my freshman year of college, I was naive and taken in by the 'Physician' part of 'Chiropractic Physician'.

 

[cool_vkb]

This looks like a very interesting thread. So i thought i would also add some fuel into the Fire without getting myself involved.

Just FYI:

Chiropractors can do a 2-3 yr residency in Chriopractic Radiology, Orthopedics, Family practice, Perdiatrics, etc. Please keep in mind, none of these residencies give any extra power of prescription or surgery to the DCs. They still do what they do without this residency.

This one is really interesting. DCs have their own Chiropractic Radiologist (DACBR) who interprets X-rays and MRIs ordered by Chiropractors just as MD or DO radilogists interpret MRIs and X-rays ordered by MDs and DOs. Most of them never say they are Chiro Radiologists, when they introduce themselves they just refer themselves as Radiologists . So this really creates confusion among general public. I'am not saying all Chiro Radiologists do but those i met they always do this.

It would be really great if someone explains what exactly does a DC Orthopedist does and also shed some light on Chiro Radiologist.

 

[cool_vkb]

And though a real chiropractor cannot prescribe drugs. A majority of chiropractic Schools offer ND and oriental medicine degrees and many of their students do dual degrees like DC/ND or DC/Oriental medicine and they do prescribe those ND and Oreintal or homeopathic medicines or nutritional supplements along with their regular DC practice.

 

[DocBR]

Thinking back on that now, I realize the DC was full of crap and did not respect the limits of his profession. Infact, I remember I went in one time when I had the flu and he tried to send me home with Bovine Colostrum and colloidal silver (which I did not accept).

Anyway, that was my freshman year of college, I was naive and taken in by the 'Physician' part of 'Chiropractic Physician'.

Oh - I should also mention that the colloidal silver was "Take as needed"

whether you agree with colloidal metals, phyto metals, etc or not - I think any reliable health practitioner would be aware of the potential toxic effects of silver.

 

[FoughtFyr]

actually - anyone can "do" drugs...you know nothing about chiropractic obviously...do you actually think that the only way to 'help' people is to prescribe a drug. maybe you need to take a class in the history of medicine; for chiropractic and medinice don't date back to Still or Palmer for that matter...it dates back to Socrates...and my friend Socrates adjusted his patients.

Actually, you need to take a class in the history of your own profession. Chiropractic does not go back to Socrates. Medicine does. Arguably Osteopathy does as Still was a trained physician. But chiropractic is the sole invention of DD Palmer. He had never trained as a physician (although there are indications he considered himself a trained "magnetist") who was working as a grocer at the time of chiropractic's founding. He eschewed all previous healing arts. He believed he found "innate intelligence", a pseudo-religious ideology for health. Chiropractors claim "the foundations for chiropractic are based on some of the most self evident truths of this universe. Universal intelligence clearly exists."

Now, no one is arguing against the existence of a supreme being. Nor are we suggesting that faith doesn't play a role in health. What I do take issue with is the role of D.D. Palmer as high priest.

I quote from his 1910 book "The Chiropractor's Adjuster" -

"I founded Chiropractic on Osteology, Neurology and Functions of bones, nerves and the manifestations of impulses. I originated the art of adjusting vertebrae and the knowledge of every principle which is included in the construction of the science of Chiropractic."​

and

"I am the originator, the Fountain Head of the essential principle that disease is the result of too much or not enough functionating. I created the art of adjusting vertebrae, using the spinous and transverse processes as levers, and named the mental act of accumulating knowledge, the cumulative function, corresponding to the physical vegetative function -- growth of intellectual and physical -- together, with the science, art and philosophy -- Chiropractic. It is now being followed, more or less, by 2,000 Chiropractors, and its use is being attempted by several other methods. It was I who combined the science and art and developed the principles thereof. I have answered the time-worn question -- what is life?"​

Besides the obvious factual error (Palmer did not "create" SMT, it has existed in some form since before the time of Socrates), he claims to be the "fountainhead" of knowledge and to be able to answer to the question "what is life?". There are others who have made similar claims over the years, including, but not limited to David Koresh, Rev. Jones, and General Idi Amin Dada.

The second issue, how does a grocer (Palmer's career in 1895) instantly become so well versed in "Osteology, Neurology, and the Fuctions of bones, nerves, and the manifestations of impulses" to found anything?

Third, how does Palmer so glibbly dismiss the thousands of years of evolution in medical knowledge that came before him? Peracles, Hippocrates, Socrates, Virchow, and Lister mean nothing? Of course leaving out the very young science of accupuncture. Yep, Palmer was smarter than the thousands of healers who came before him. He alone is the "Fountainhead". Please.

Lastly, look at Palmer's motivation (again from his book):

"One question was always uppermost in my mind in my search for the cause of disease. I desired to know why one person was ailing and his associate, eating at the same table, working in the same shop, at the same bench, was not. Why? What difference was there in the two persons that caused one to have pneumonia, catarrh, typhoid or rheumatism, while his partner, similarly situated, escaped? Why? This question had worried thousands for centuries and was answered in September, 1895."​

Actually, we now have the answer to this worrisome question, and it isn't chiropractic. Our modern understanding of the immune system, down to the protien sythesis level, has specifically determined the answers in a very provable manner.

i am not slapping the allopathic field in the face...because i believe and respect the allopathic practices' contibutions to healthcare...

Gee, thanks!

no i am slapping you in the face and your ignorance...are you that niave to think that some medical doctors aren't quacks either

Ahh, the age old dodge of the snakeoil salesman - "some doctors are bad too!" Yes, that is true, but at some point in their licensing and credentialling process it was demonstrated that the allopath learned techniques that could actually help the patient. If they chose to abandon those principle later then the extensive QI/QA mechanisms in place in medicine (and absent in chiropractic) will "catch" them.

...sheesh...you might have the brains to get into med school...by the way so do i...

You might, but on average your classmates don't.

but based on your 'social apptitude' i wonder if you have what it takes to actually be empathetic of your patient and care about what might be best for them...

What is best for them is an open relationship with an adequate discussion of the proven risks, benefits and alternatives to therapy are discussed. There are simply no proven benefits to chiropractic.

so when you drop your scalpal on the cutting room floor and tweak a nerve don't come to one of us and ask for a little help - idiot!
yours truely - a future dc

Yeah, don't worry, we won't.

Yours Truly,

- H, MD, MPH

 

[FoughtFyr]

Chiropractors can do a 2-3 yr residency in Chriopractic Radiology, Orthopedics, Family practice, Perdiatrics, etc. Please keep in mind, none of these residencies give any extra power of prescription or surgery to the DCs. They still do what they do without this residency.

And these residencies are NOT hospital based, so there is no opporitunity to assess the full natural course of disease (I'm sorry, dis-ease), nor is there any chance to treat patients with significant pathology or high acuity. These are part and parcel experiences for any MD/DO's training.

- H

 

[BMW19]

I am a chiropractor who is now a second year DO student. I have been involved in this argument so many times it makes me want to vomit! In a nutshell most chiros become desparate due to only seeing 10-15% of the population and will do whatever is necessary to get by HOWEVER, there are very good ones out there that have diagnosed METS on x-ray or caught AAA. The one I worked with did a fellowship in sports injuries and was great at it. There are bad ones of course just like there are bad DO's like the one in FL who injected an almost lethal dose of Botox into two patients. Bad MD's like the one who was giving cancer patients IV vitamins!

Chiro radiologists are actually quite good at static x-rays and do 3 extra years of just reading plain films. I just wonder why they didn't just become a real radiologist!

If you have REAL questions about becoming a chiro or going on to become a DO/MD from chiro or chiro school please PM me. Otherwise this thread should be closed it has been discussed adnauseam!!

BMW-

This looks like a very interesting thread. So i thought i would also add some fuel into the Fire without getting myself involved.

Just FYI:

Chiropractors can do a 2-3 yr residency in Chriopractic Radiology, Orthopedics, Family practice, Perdiatrics, etc. Please keep in mind, none of these residencies give any extra power of prescription or surgery to the DCs. They still do what they do without this residency.

This one is really interesting. DCs have their own Chiropractic Radiologist (DACBR) who interprets X-rays and MRIs ordered by Chiropractors just as MD or DO radilogists interpret MRIs and X-rays ordered by MDs and DOs. Most of them never say they are Chiro Radiologists, when they introduce themselves they just refer themselves as Radiologists . So this really creates confusion among general public. I'am not saying all Chiro Radiologists do but those i met they always do this.

It would be really great if someone explains what exactly does a DC Orthopedist does and also shed some light on Chiro Radiologist.