Comments on Chiropractic

[Nemo]

My hobby website is currently under construction. However, I do have some decent criticisms of Chiropractic and important links on that topic already posted.

http://ccffm.proboards36.com/index.cgi?board=Chiropractic

The level of quackery in this field is so extreme that it should be dissolved ( maybe 10% are evidence-based)...In my view, what little the Chiropractor has to offer- SMT for LBP- may be performed by the physical therapist.

I recommend that MD's do not refer to DCs. They cannot be trusted.

Ken Niemann DC

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[OSUdoc08]

My hobby website is currently under construction. However, I do have some decent criticisms of Chiropractic and important links on that topic already posted.

http://ccffm.proboards36.com/index.cgi?board=Chiropractic

The level of quackery in this field is so extreme that it should be dissolved ( maybe 10% are evidence-based)...In my view, what little the Chiropractor has to offer- SMT for LBP- may be performed by the physical therapist.

I recommend that MD's do not refer to DCs. They cannot be trusted.

Ken Niemann DC

An osteopathic physician who specializes in OMM would also be appropriate.

 

[Nemo]

An osteopathic physician who specializes in OMM would also be appropriate.

True. I don't think they do much better in terms of outcomes than the chiropractor, but at least you can rely on the DO for a proper Ddx and the MD referring won't subject his patient to a host of quacky theories.

Ken

 

[Oculus Sinistra]

The level of quackery in this field is so extreme that it should be dissolved ( maybe 10% are evidence-based)...In my view, what little the Chiropractor has to offer- SMT for LBP- may be performed by the physical therapist.
I recommend that MD's do not refer to DCs. They cannot be trusted.
Ken Niemann DC

Wow. You are a DC recommending that we do not refer patients to DC's?

 

[Nemo]

Wow. You are a DC recommending that we do not refer patients to DC's?

Yea, pretty damn sad, isn't it?....A waste of 4 years and 100k.

Your odds of finding a chiropractor who is ethical and evidence-based are too low to bother with it. Quackery is embraced by the schools, the governing bodies, the board of examiners, etc.- nearly everyone except a small group of research based DCs that everyone ignores.

Sure, it may offer a modicum of relief for certain types of back pain....likely a dPAG mediated pain inhibition reflex via mechanoreceptor stimulation...but some well designed studies also say it lacks efficacy.

I would send the patient to a PT instead....You never know what the DC will tell the patient or do to them or try to sell them....

 

[humuhumu]

Here's my take on chiropractic (it's a blog entry I wrote a couple months ago):

What do chiropractic adjustments do to your anatomy?

 

[Nemo]

Here's my take on chiropractic (it's a blog entry I wrote a couple months ago):

What do chiropractic adjustments do to your anatomy?

You write very well and it was a good article, but I cannot believe Haldeman offered what he did.

Release part of a joint capsule that has become entrapped in facet joints, joints between pairs of vertebrae that have been shown to be very sensitive to pain.

Reposition part of an intervertebral disc (the rubbery disc between successive vertebrae).

Loosen fibrous tissue that formed in a previous injury.

Inhibit overactive reflexes in muscles of the spine or limbs.

Reduce the compression or irritation of nerves.

I would only agree with point #1.

Chiropractors have completely failed in their assessment techniques. That is, to truly assess vertebral position they need 3-D studies which are currently unavailable to clinicians. So this begs the question "what happens when they 'adjust' a false positive?" Do they create "subluxations"?

These HVLA manipulations facilitate some muscles, so why should I think that that they are good for muscle spasms. Moreover, I don't think a single paper has been published that identifies which muscles are stimulated and which muscles are inhibited by the manipulations.

Also, the effects are very short lived. Many chiros, for example, will tout a sympathetic discharge by the manipulation but I have never seen these last more than a minute or so and may have something to do with the fear of getting your neck twisted.

The old "foot on the garden hose" analogy is dead...or at least should be. The IVF is large enough to accommodate minor vertebral malpositions.

But yea, it is quite possible the capsule could become pinched or something like that. Theoretically chiropractic can help that.

If you came to my office, I would have shown you a bunch of exercises to work the shoulder depressors (mid and lower traps) that may inhibit the upper traps and levator scapulae. I honestly don't think stretching would help that much...massage therapy might though....The problem is that chiros don't really get paid much for corrective exercise so they do very little of it and emphasize "the adjustment" whatever that is....

 

[Nemo]

As you know,the crack of the adjustment ( cavitation) is gas coming out of solution. I have no idea if the facet joint goes back to where it was once the gas re-dissolves.

 

[OSUdoc08]

True. I don't think they do much better in terms of outcomes than the chiropractor, but at least you can rely on the DO for a proper Ddx and the MD referring won't subject his patient to a host of quacky theories.

Ken

If you are convinced of this, then you must also be convinced that physical therapy would not help the outcome either.

 

[humuhumu]

You write very well and it was a good article, but I cannot believe Haldeman offered what he did.



I would only agree with point #1.

Chiropractors have completely failed in their assessment techniques. That is, to truly assess vertebral position they need 3-D studies which are currently unavailable to clinicians. So this begs the question "what happens when they 'adjust' a false positive?" Do they create "subluxations"?

These HVLA manipulations facilitate some muscles, so why should I think that that they are good for muscle spasms. Moreover, I don't think a single paper has been published that identifies which muscles are stimulated and which muscles are inhibited by the manipulations.

Also, the effects are very short lived. Many chiros, for example, will tout a sympathetic discharge by the manipulation but I have never seen these last more than a minute or so and may have something to do with the fear of getting your neck twisted.

The old "foot on the garden hose" analogy is dead...or at least should be. The IVF is large enough to accommodate minor vertebral malpositions.

But yea, it is quite possible the capsule could become pinched or something like that. Theoretically chiropractic can help that.

If you came to my office, I would have shown you a bunch of exercises to work the shoulder depressors (mid and lower traps) that may inhibit the upper traps and levator scapulae. I honestly don't think stretching would help that much...massage therapy might though....The problem is that chiros don't really get paid much for corrective exercise so they do very little of it and emphasize "the adjustment" whatever that is....

I'm not familiar enough with the literature to say anything authoritative, but my impression is that most of the proposed anatomical and physiological effects of chiropractic manipulation, though plausible, haven't been demonstrated adequately. But who's going to do the research? Unfortunately there are very few qualified investigators who are interested in putting chiropractic on a sound scientific footing. There's some interesting work out there, but it's just scratching the surface.

I can say that, for my relatively minor musculoskeletal complaints, chiropractic manipulations have made a difference (e.g., increased range of motion and no pain at the extremes of neck rotation and flexion). My back feels better now that it has in years. I also suspect that OMM would have achieved the same results.

 

[Oculus Sinistra]

Yea, pretty damn sad, isn't it?....A waste of 4 years and 100k.

Your odds of finding a chiropractor who is ethical and evidence-based are too low to bother with it. Quackery is embraced by the schools, the governing bodies, the board of examiners, etc.

I would send the patient to a PT instead....You never know what the DC will tell the patient or do to them or try to sell them....

Glad to know!
My experience with chiropractors is limited to a single anecdote -- my mother fell at work about 10 years ago and saw a chiropractor pretty much every couple days for two years until she decided
1) It wasn't working
2) It was costing too much
She would be in intense pain, see him, he'd help her for about a day before the pain came back. Luckily the pain eventually went away. Perhaps she saw an MD about it -- she doesn't really tell me about those things.

 

[USCguy]

if you are looking for chiropractic criticism from practicing DC's, you can look at

http://chirotalk.proboards3.com/

There are a bunch of former DC's or people in your situation that wasted 4 years and 120k, only to be left doing spinal screenings on the weekends at walmart as part of an "associateship"

I never gave into chiropractic criticism until I actually heard it from the people in the field.

Might you be the same "Nemo" from this webforum?

 

[Nemo]

if you are looking for chiropractic criticism from practicing DC's, you can look at

http://chirotalk.proboards3.com/

There are a bunch of former DC's or people in your situation that wasted 4 years and 120k, only to be left doing spinal screenings on the weekends at walmart as part of an "associateship"

I never gave into chiropractic criticism until I actually heard it from the people in the field.

Might you be the same "Nemo" from this webforum?

Yea, same guy....hope you're doing well.

I might as well add the following:

www.chirobase.org

 

[TypeA]

I don't think it can be generalized that all chiropractors are quacks. I did go to a bad one and then I found a husband/wife team that were incredible. They did what MDs had been unable to do for me...pain relief.

I was run over by a truck and various other things...couldn't stand at one point. No problems now. The explanations they gave were confirmed later by and MD. I don't believe, despite a kabillion years of eastern medicine, that chiropractic is at an appropriate regulatory level so to speak. Unfortunately, the ethical practitioners must shoulder the burden of wading through the crap that their less than competent collegues have created.

Let's not generalize too much.

 

[Squad51]

I don't believe, despite a kabillion years of eastern medicine, that chiropractic is at an appropriate regulatory level so to speak. Unfortunately, the ethical practitioners must shoulder the burden of wading through the crap that their less than competent collegues have created.

Let's not generalize too much.

Umm, do keep in mind that Chiropractic is not "eastern medicine", nor is it very old at all. Chiropractic was "created" by DD Palmer in September, 1895. He supposedly "cured" a deaf janitor with spinal manipulation and in his zeal to discover why different people, somewhat exposed to similar conditions had different rates of illness, he "created" the principles of chiropractic. So there is no "long history", nor are there really any traditions handed down with any proof of efficacy - as DD and his son BJ and other family members kept tight control of things until the 1960s.

What exists now are varying schools of philosophy and education, each radically different than the other, all claiming to be "chiropractic". Chiropractors often include "eastern medicine" into their practice in order to lend a sense of legitimacy to the affairs - but the bottom line is thatchiropractic is not scientifically supported for ANYTHING except low back pain and in the treatment of LBP it is only as effective as traditional medicine 9however, patients report higher satisfaction with chiropractic - despite no difference in clinical outcome).

 

[f_w]

http://anatomynotes.blogspot.com/2006/01/what-do-chiropractic-adjustments-do-to.html

-- Image 'c' was acquired in a slightly oblique plane compared with image 'd'. Any difference in the appearance of the facet joint can be related to the difference in positioning.

 

[hokte]

Yea, pretty damn sad, isn't it?....A waste of 4 years and 100k.

Your odds of finding a chiropractor who is ethical and evidence-based are too low to bother with it. Quackery is embraced by the schools, the governing bodies, the board of examiners, etc.- nearly everyone except a small group of research based DCs that everyone ignores.

Sure, it may offer a modicum of relief for certain types of back pain....likely a dPAG mediated pain inhibition reflex via mechanoreceptor stimulation...but some well designed studies also say it lacks efficacy.

I would send the patient to a PT instead....You never know what the DC will tell the patient or do to them or try to sell them....

I went to school at Parker, and at that time they were very basic science oriented. Of course there were always groups of students that were into the other stuff. When I first was introduced to chiropractic I didnt realize people used it for anything else but back pain. After school I came in contact with a doctor that really made me question what I had gotten into. He got great results with his patients, but the methods were frightening. I realized that he is just an individual and doesn't represent the whole profession. Every profession has goofy people, maybe we just have a few more than normal. Anyway I'm doing the medicine thing now, but I will most definately use manipulation in my practice once I get out of school.

 

[f_w]

Every profession has goofy people, maybe we just have a few more than normal.

Like this one ?

http://msnbc.msn.com/id/12208638/

 

[BMW19]

I am a former chiropractor who is now in DO school. I do agree that there are certain aspects of the profession that are dubious. However, there are some DC's that are ethical, well trained and respected. In fact several that I know have found path on x-ray, exams and in lab values. If they even saved one pt. from heartache and pain by making a correct referral then they have some value. As far as manipulation is concerned, there is proven value in LB manipulation if you do a search. Unfourtunately, most of it is not done by chiros which is why they get so much flack. Please do not pick out stories like the one above and say that it is representative of a profession. Perhaps we can find the story of the DO in FL that decided to inject a pure form of Botox to two people and paralyzed them so he could save money on the correct meds. Or the MD that was "curing people" of all sorts of ailments by injecting Hydrogen Peroxide into their veins. Please....people.

As far as the DO students and DO's that bash chiros they should be ashamed. Don't sit there and tell me how "different" osteopathy is from chiro in terms of manipulation because I have been thru both curriculums. The techniques are VERY similar. When a DO does it, it is a powerful treatment but when a chiro does it is quackery and dangerous. The usual Hippocracy.

BMW-

Like this one ?

http://msnbc.msn.com/id/12208638/

 

[f_w]

That case is actually encouraging. The chiro board for once decided to act against a quack, just when I thought they had no self-regulation at all.

 

[OSUdoc08]

I am a former chiropractor who is now in DO school. I do agree that there are certain aspects of the profession that are dubious. However, there are some DC's that are ethical, well trained and respected. In fact several that I know have found path on x-ray, exams and in lab values. If they even saved one pt. from heartache and pain by making a correct referral then they have some value. As far as manipulation is concerned, there is proven value in LB manipulation if you do a search. Unfourtunately, most of it is not done by chiros which is why they get so much flack. Please do not pick out stories like the one above and say that it is representative of a profession. Perhaps we can find the story of the DO in FL that decided to inject a pure form of Botox to two people and paralyzed them so he could save money on the correct meds. Or the MD that was "curing people" of all sorts of ailments by injecting Hydrogen Peroxide into their veins. Please....people.

As far as the DO students and DO's that bash chiros they should be ashamed. Don't sit there and tell me how "different" osteopathy is from chiro in terms of manipulation because I have been thru both curriculums. The techniques are VERY similar. When a DO does it, it is a powerful treatment but when a chiro does it is quackery and dangerous. The usual Hippocracy.

BMW-

Does 'Hippocracy' = "medical hypocrisy"?

 

[BMW19]

Yes, I thought I'd put a little play on words in there. At least someone caught it!

Does 'Hippocracy' = "medical hypocrisy"?

 

[hokte]

I am a former chiropractor who is now in DO school. I do agree that there are certain aspects of the profession that are dubious. However, there are some DC's that are ethical, well trained and respected. In fact several that I know have found path on x-ray, exams and in lab values. If they even saved one pt. from heartache and pain by making a correct referral then they have some value. As far as manipulation is concerned, there is proven value in LB manipulation if you do a search. Unfourtunately, most of it is not done by chiros which is why they get so much flack. Please do not pick out stories like the one above and say that it is representative of a profession. Perhaps we can find the story of the DO in FL that decided to inject a pure form of Botox to two people and paralyzed them so he could save money on the correct meds. Or the MD that was "curing people" of all sorts of ailments by injecting Hydrogen Peroxide into their veins. Please....people.

As far as the DO students and DO's that bash chiros they should be ashamed. Don't sit there and tell me how "different" osteopathy is from chiro in terms of manipulation because I have been thru both curriculums. The techniques are VERY similar. When a DO does it, it is a powerful treatment but when a chiro does it is quackery and dangerous. The usual Hippocracy.

BMW-

Well said BMW..... When did you finish chiropractic school?

 

[BMW19]

2003

Well said BMW..... When did you finish chiropractic school?

 

[hokte]

2003

You were smart and didn't wait. I was out for around 5 years before going back to school. Are you enjoying yourself? I'd like to hear your opinion on how the curriculum compare.

 

[USCguy]

What schools did you all go to? Life?

My brother's wife's sister (follow that?) graduated from Life in 2000. She is no longer practicing either.

How do you decide who is and who isn't ethical (some are obvious)? If you treat everyone that walks in your door, are you unethical? If you charge too much, are you unethical(how much is too much)? If you say toggle recoil will get rid of your headaches, are you unethical? Just trying to get an idea of what you all think.

For the person who said that Parker was very basic science oriented, how do you counter the claim of someone who says that you learn lots of pathologies that you will never be able to treat with chiropractic. This is a statement I heard from a former DC. The DC said one of the PhD professors at their chiro school said this.


thanks

 

[hokte]

What schools did you all go to? Life?

My brother's wife's sister (follow that?) graduated from Life in 2000. She is no longer practicing either.

How do you decide who is and who isn't ethical (some are obvious)? If you treat everyone that walks in your door, are you unethical? If you charge too much, are you unethical(how much is too much)? If you say toggle recoil will get rid of your headaches, are you unethical? Just trying to get an idea of what you all think.

For the person who said that Parker was very basic science oriented, how do you counter the claim of someone who says that you learn lots of pathologies that you will never be able to treat with chiropractic. This is a statement I heard from a former DC. The DC said one of the PhD professors at their chiro school said this.


thanks

To me unethical is spouting false claims about what maniupulation can treat or to encourage a patient to discontinue his/her meds without knowledge the person's MD or DO. Of course that's just a few things, but you get my drift.... I think to say toggle recoil will get rid of your headaches, is not a good thing. To me a better choice of words would be that many people find relief with that technique. I think there are many disesase processes that maniupulation has been found to help, but it's a disservice to the profession and the patient to say that it can offer a definate cure.

I realize that many of the path taught in Chiro school go beyond the relam of chiro treatments. In my opinion you have to recognize the pathology in order to know what not to treat, and then the proper physician to handle that kind of thing. Many diseases, even visceral, manifest themselves as a musculosckeletal complaint. For many patients the first stop may be the DC, so that DC has to be able to recognize abnormalities. I heard people with this complaint the whole time I went to school, and to me it made no sense. If you want the responsibility of caring for patients, even just the vertebrae, you have to know about the whole package.

 

[bkwash]

I have been to a chiro b/f and while i really did feel like they were helping me ( i have a slight mis align from carrying a bookbag, lifting weights and sports) I did feel like they were "taking me for a ride". I would come into the office and they would pop my back and send me on my way and they had me on this long "treatment plan" that I halted after 3 sessions.

My question is what is the alternative to get alignment corrections? I think I do agree with the fact that everyday life misaligns your spine and it has to be put back, but i fear the people who are supposed to be doing it are corrupt...any thoughts?

 

[OSUdoc08]

I have been to a chiro b/f and while i really did feel like they were helping me ( i have a slight mis align from carrying a bookbag, lifting weights and sports) I did feel like they were "taking me for a ride". I would come into the office and they would pop my back and send me on my way and they had me on this long "treatment plan" that I halted after 3 sessions.

My question is what is the alternative to get alignment corrections? I think I do agree with the fact that everyday life misaligns your spine and it has to be put back, but i fear the people who are supposed to be doing it are corrupt...any thoughts?

Go to an osteopathic physician who specializes in osteopathic manipulative medicine.

 

[hokte]

Go to an osteopathic physician who specializes in osteopathic manipulative medicine.

That doesn't cut it....osteopathic physicians aren't perfect either.

I believe you should choose a DC, MD or DO almost like you were hiring an employee. Talk to them find out their philosophies and protocols and go from there. We have good and bad people in all professions and when it comes to your body you have the right to find out what a physician is all about before getting into treatment. If a doctor doesn't want to do this maybe you should find someone else. It may take some time, but there are definately DC's and DO's out there that you would be comfortable with.

 

[OSUdoc08]

That doesn't cut it....osteopathic physicians aren't perfect either.

I believe you should choose a DC, MD or DO almost like you were hiring an employee. Talk to them find out their philosophies and protocols and go from there. We have good and bad people in all professions and when it comes to your body you have the right to find out what a physician is all about before getting into treatment. If a doctor doesn't want to do this maybe you should find someone else. It may take some time, but there are definately DC's and DO's out there that you would be comfortable with.

DO's can provide treatment methods other than manipulation. DC's cannot. This was the basis of my post.

 

[humuhumu]

Here in Vermont, DOs aren't nearly as visible as DCs. Maybe it's just a numerical difference: I'm sure there are many more DCs than DOs, especially DOs that specialize in manipulative therapy. The only DO I've met around here is an interventional radiologist. I went to a chiropractor a few months ago because, honestly, it didn't even occur to me to look up an osteopathic physician.

 

[hokte]

DO's can provide treatment methods other than manipulation. DC's cannot. This was the basis of my post.

Kinda like a "one stop shop". I can see what you mean and that is certainly more convient to the patient. Sorry I misunderstood your post...

 

[OSUdoc08]

Kinda like a "one stop shop". I can see what you mean and that is certainly more convient to the patient. Sorry I misunderstood your post...

Exactly.

 

[PublicHealth]

That doesn't cut it....osteopathic physicians aren't perfect either.

I believe you should choose a DC, MD or DO almost like you were hiring an employee. Talk to them find out their philosophies and protocols and go from there. We have good and bad people in all professions and when it comes to your body you have the right to find out what a physician is all about before getting into treatment. If a doctor doesn't want to do this maybe you should find someone else. It may take some time, but there are definately DC's and DO's out there that you would be comfortable with.

 

[bkwash]

thanks for the replies...

 

[wayttk]

Wow. You are a DC recommending that we do not refer patients to DC's?

Nemo is not a licensed DC. He holds no license in any state, or country.

It might also be noteworthy to mention that he failed his part IV national boards twice and has yet to pass it.

 

[Squad51]

Nemo is not a licensed DC. He holds no license in any state, or country.

It might also be noteworthy to mention that he failed his part IV national boards twice and has yet to pass it.

Intersting response from a DC who him/herself claims (on another thread) "I am legally able to draw blood, order labs, and diagnose any medical condition, within, OR outside my scope of practice." and "I also, regularly advise my patients on pharmcological treatment." {emphasis added}

I'd rather take advice from an unlicensed DC who knows their limits than a licensed one with no clue...

 

[dnw826]

I actually used to go to an excellent DC. I had severe back pain from a car accident aggravated by a botched intrathecal. My DC fixed it in 4 weeks. It was like having my life back, really. Doctors and Physical therapists had so far failed. In my town, DC's are more respected than the doctors. There are a lot of factories and back injuries, and the DC's always fix everybody up. I was actually thinking of going to Chiropractic school, but I am too into surgery to give that up.

 

[OSUdoc08]

I actually used to go to an excellent DC. I had severe back pain from a car accident aggravated by a botched intrathecal. My DC fixed it in 4 weeks. It was like having my life back, really. Doctors and Physical therapists had so far failed. In my town, DC's are more respected than the doctors. There are a lot of factories and back injuries, and the DC's always fix everybody up. I was actually thinking of going to Chiropractic school, but I am too into surgery to give that up.

Did you ever think of trying a D.O.? It may have been easier to go to a one-stop-doc then have to swap between a D.C. and an M.D. for treatment. It would have probably saved you alot of money as well.

P.S. Are DC's more respected than DO's in your area? If so, it is obviously out of ignorance, since the people likely don't realize that the DO can do any treatment that a DC can do plus more.

 

[PublicHealth]

I actually used to go to an excellent DC. I had severe back pain from a car accident aggravated by a botched intrathecal. My DC fixed it in 4 weeks. It was like having my life back, really. Doctors and Physical therapists had so far failed. In my town, DC's are more respected than the doctors. There are a lot of factories and back injuries, and the DC's always fix everybody up. I was actually thinking of going to Chiropractic school, but I am too into surgery to give that up.

Where are you (state is fine) and what school did this DC attend? It's DCs like this who deserved to be recognized. I've heard from a DC student friend of mine that there is an effort to develop "Best Practice Guidelines" in chiropractic. Great move if you ask me!

 

[PublicHealth]

Are DC's more respected than DO's that practice OMM?

If so, it is obviously out of ignorance.

DOs that practice OMM are very few and far between. According to the AOA, less than 0.2% of DO school graduates pursue residency training in OMM.

 

[OSUdoc08]

DOs that practice OMM are very few and far between. According to the AOA, less than 0.2% of DO school graduates pursue residency training in OMM.

It is easy to find one in just about every major city in the U.S. It is also pretty easy to find them in rural areas, especially in states that have DO schools.

You do not have to complete a residency in OMM in order to use it. Every person who attends an AOA school can use OMM in their practice.

 

[humuhumu]

Does anyone have a ballpark estimate of the ratio of chiropractors to DO's that do OMM? 3 to 1? 10 to 1?

 

[OSUdoc08]

Does anyone have a ballpark estimate of the ratio of chiropractors to DO's that do OMM? 3 to 1? 10 to 1?

DC's don't do OMM.

 

[humuhumu]

DC's don't do OMM.

I didn't mean to imply that they do. I'm looking for a ratio of DCs (that do chiropractic manipulation) to DOs that do OMM.

 

[ForamenMagnumPI]

So...this is sort of tangential, but reading this thread made me think about it. I'm on a rotation in a rural town in Wisconsin, and many of the patients keep coming in and saying that their pain is so much better since they've started going to "choir practice". Well, it took a week, but I finally realized that they were just mutilating the word "chiropractor". I was confused as to how choir practice would alleviate pain. I wonder if it would be just as good as a chiropractor. And cheaper too.

 

[dnw826]

Did you ever think of trying a D.O.? It may have been easier to go to a one-stop-doc then have to swap between a D.C. and an M.D. for treatment. It would have probably saved you alot of money as well.

P.S. Are DC's more respected than DO's in your area? If so, it is obviously out of ignorance, since the people likely don't realize that the DO can do any treatment that a DC can do plus more.

We actually have quite a few DO's, but they are all OB's. I actually have wanted to go for my DO since meeting one of my doc's who was a DO when I was 15. Unfortunately, I can not find any jobs for my dh nearby any of the DO schools that I would want to go to. He is a chemist, and it's slim pickings. And we can't afford for him not to work.

 

[nebrfan]

I didn't mean to imply that they do. I'm looking for a ratio of DCs (that do chiropractic manipulation) to DOs that do OMM.

All DCs do manipulation. It's all they CAN do.

 

[PublicHealth]

All DCs do manipulation. It's all they CAN do.

Wrong.

http://www.chiroweb.com/archives/ahcpr/chapter5.htm

"C. Legal Scope of Practice

Chiropractic is licensed and regulated in every State (Lamm, 1995). State statutes and regulations determine the scope of clinical procedures chiropractors may legally perform in their respective jurisdictions. Within these legal boundaries individual practitioners may practice as they wish. Providing care for musculoskeletal conditions using manipulation as a primary intervention is within the legal scope of chiropractic practice in all 50 States. The legal right to use other procedures including modalities, myofascial work, acupuncture, and nutritional therapy varies from State to State.

The United States and State constitutions empower States to grant licensure and to regulate scope of practice (Christensen, 1993). State regulatory agencies, established by the legislature of each State, manage the licensing process and disseminate information regarding scope of practice. In most States, the extent of the scope of practice will be influenced by laws enacted through legislation, policies, or guidelines issued by the regulatory agency responsible for licensing, and by court decisions.

All States currently exclude prescribing drugs and performing major surgery from chiropractic practice. Otherwise, differences in scope of practice vary considerably from State to State. These variations are categorized here as: (1) restrictive, (2) expansive, or (3) intermediate. States are considered restrictive in scope if they explicitly prohibit chiropractors from performing two or more of the following: venipuncture for diagnostic purposes, use of physiotherapy modalities, dispensing of vitamin supplements, or provision of nutritional advice to patients. Michigan is an example of a State with a restricted scope of practice (FCLB, 1996). In Michigan, the license limits chiropractors to the use of spinal analysis and x-ray to detect spinal subluxations and misalignments and the administration of spinal adjusting procedures to correct these subluxations. Michigan prohibits the use of any type of physiotherapy, a rather standard adjunct to chiropractic procedures in most jurisdictions. Chiropractors may give patients advice about nutrition but cannot dispense nutritional supplements. They are not allowed to perform venipuncture, even for diagnostic purposes. Five other States share similar restrictions with Michigan and can also be considered restrictive: Mississippi, New Jersey, South Carolina, Tennessee, and Washington.

A State classified as having an expansive scope of practice allows three or more of the following practices: specialty diagnostic procedures, pelvic and rectal examinations, venipuncture for laboratory diagnosis, signing of birth and death certificates, and acupuncture using needles. An example of a State with an expansive scope is Oregon (FCLB, 1996). In Oregon, chiropractors are allowed to perform minor surgery, proctology, and obstetrical procedures. They also employ "chiropractic diagnosis, treatment and prevention of body dysfunctions, correction, maintenance of the structural and functional integrity of the neuromusculoskeletal system and the effects thereof or interferences therewith by the utilization of all recognized and accepted chiropractic diagnostic procedures and the employment of all rational therapeutic measures as taught in approved chiropractic colleges" (FCLB, 1996). Chiropractors practicing in Oregon may utilize physiotherapy devices, perform venipuncture to collect blood specimens for laboratory diagnosis, give nutritional advice, and dispense nutritional supplements from their offices. Three other States share the characteristics of an expansive scope of practice: Idaho, Ohio, and Oklahoma.

The remaining 40 States have practice statutes that fall somewhere in between the extremes of expansive or restrictive. An example of a state with an intermediate scope of practice is Kansas, where chiropractors may use venipuncture for diagnostic purposes, employ acupuncture using needles if certified, and utilize physiotherapies, but may not perform pelvic examinations or sign birth or death certificates. Lamm (1995) published a report that provides detailed information regarding specific diagnostic and treatment procedures that are either allowed or prohibited in 46 States whose board representative responded to a questionnaire."