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- Apr 1, 2004
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FoughtFyr said:There isn't a substitute for medical school...
- H
Did you really mean to make a blanket statement such as this?
FoughtFyr said:There isn't a substitute for medical school...
- H
Sosumi said:Does anyone know if the treatment modality of electrotherapy along your back is mainly chiropractic, or is it also common among physical therapy and orthopedics?
I'm trying to figure it out because my aunt and uncle had been going to a "doctor" who does this and I think gives them dietary supplements of glucosamine and chondroitin for it, but never mention other traditional medicines. They're not sure what kind of doctor he is. Their health insurance covered the visits.
I'm concerned because my aunt recently hurt her neck due to a manipulation by this "doctor" and it really made her feel worse -- she couldn't even turn her neck for a few days! I made her go see a physician who prescribed for her a muscle relaxant and NSAID which is the traditional pharmacotherapy, and it's worked for her moreso than the previous doctor's treatment.
billydoc said:I've been using elctric stem quite a bit in my acupunctuture Tx. It's not for everybody,but works quite well when indeed necessary.
Sosumi said:Does anyone know if the treatment modality of electrotherapy along your back is mainly chiropractic, or is it also common among physical therapy and orthopedics?
I'm trying to figure it out because my aunt and uncle had been going to a "doctor" who does this and I think gives them dietary supplements of glucosamine and chondroitin for it, but never mention other traditional medicines. They're not sure what kind of doctor he is. Their health insurance covered the visits.
I'm concerned because my aunt recently hurt her neck due to a manipulation by this "doctor" and it really made her feel worse -- she couldn't even turn her neck for a few days! I made her go see a physician who prescribed for her a muscle relaxant and NSAID which is the traditional pharmacotherapy, and it's worked for her moreso than the previous doctor's treatment.
FoughtFyr said:Cool. So why have them? We already have PTs. I mean if all they are doing is PT, why should they be regulated by separate broads and be under their own statutory regulation? Why the need to call themselves "physicians"? Are PTs "physical therapy physicians"? And where are the studies to prove that chiropractic is more effective (in terms of either cost or efficacy) than PT? Where are the controls in terms of QI/QA? And where are the limits on scope - I don't see PTs claiming to treat otitis media, ADHD, or allergies. Nor do I see PT claiming they can serve as primary care physicians...
- H
lawguil said:Question? Were they an instructor/adjunct or faculty member (professor, associate professor, assistant professor)?
As an example, I took an Anatomy course from an RN who also had a masters degree in education. She wasn't faculty! She taught 6 credits/year. Many schools do this to avoid hiring full-time faculty, save money, and there are many non-PhD's who can do a fine job of teaching undergrads/professional students.
seanjohn said:I was just wondering if chiropractic education was equivalent to that of a medical doctor. Many chiros claim that their education is equivalent, but somehow I find it hard to believe.
Can anyone elaborate with statistics and their thoughts?
Thanks.
TofuBalls said:My family and I use a chiropractor for our primary care doctor.
I remember when my wife went into premature labor, our chiro made the diagnosis immediately just by the malposition of her spine. From the information he got from her x-rays and manipulations, he knew to start her on antibiotics to prevent chorioamnionitis.
But his medical expertise did not stop there, since my son was born at 35 weeks, our family chiro had the presence of mind to notice the retractions and grunting of his breathing and proceded to intubate him there on the spot. After a few manipulations he was able to diagnose my little boy with Respiratory Distress Syndrome. He immediately treated him with surfactant and was weened off the vent in a matter of days. In addition to this, he was very adept at placing umbilical arterial and venous lines.
I also have a friend who developed a symptomatic basilar artery aneurysm. He was hell bent on going to a neurosurgeon but changed his mind after I told him about my chiro. Since then, he has had percutaneous coiling done at the chiro's office on an outpatient basis.
Of late, while I was performing anethesia for a right lung transplant, I had to do a quick phone consult with my chiro since I don't trust the medical training either I or my attending had. Since I had floated a Swan-Ganz catheter in my patient, I wanted my friendly family chiro to explain the determinants of mixed venous oxygenation and the elements of the Fick equation. He had a little trouble dumbing it down for someone like me to understand. He really saved the day when I had to clamp off the right lung and rely on one lung ventilation. He explained the basics of one lung ventilation under anesthesia to me as well as why my Pulmonary Artery pressures were so high. Although the patient thanked me for a perfect anesthetic, I know my family chiro was the real hero. If I only knew manipulations instead of all this worthless damn clinical medicine...
I won't even go into my Aunt's vaginitis, he cured that too!
I hope this helps!
FoughtFyr said: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).
Many community colleges hire DCs to each basic anatomy classes, and they are considered faculty.
- H
FoughtFyr said:Here is where I'll disagree with you. MDs can be, and are, hired to teach at Universities on topics other than medicine. Most faculty hiring standards (such as Harvard's "purple book") include the MD/DO as meeting the basic educational requirement to be faculty. The DC generally does not. While there has been one case, oft quoted, of a DC acting as a clinical instructor, to my knowledge there are no professors hired on the strength of a DC alone (although DC, PhDs have been, that is as a result of the PhD, not the DC).
I agree you've earned the title. I would expect you to introduce yourself that way in professional conversation. But, much like the PharmD, DNP, or PhD researcher, when in an academic medical center and in patient care areas I would expect that you wouldn't be called "doctor" to avoid staff and patient confusion. This is not the case in every medical center, but with the proliferation of doctoral degrees (as you point out) more and more centers are addressing this with specific policies.
I am not trying to take away what you have earned, I do respect the work you've done. For me you are like a cleric in a religion I do not practice. I respect the work you do and the effort it took to get there, but I don't subscribe to the basis behind it. Please do not interpret my post otherwise.
- H
FoughtFyr said:Here is where I'll disagree with you. MDs can be, and are, hired to teach at Universities on topics other than medicine. Most faculty hiring standards (such as Harvard's "purple book") include the MD/DO as meeting the basic educational requirement to be faculty. The DC generally does not. While there has been one case, oft quoted, of a DC acting as a clinical instructor, to my knowledge there are no professors hired on the strength of a DC alone (although DC, PhDs have been, that is as a result of the PhD, not the DC).
I agree you've earned the title. I would expect you to introduce yourself that way in professional conversation. But, much like the PharmD, DNP, or PhD researcher, when in an academic medical center and in patient care areas I would expect that you wouldn't be called "doctor" to avoid staff and patient confusion. This is not the case in every medical center, but with the proliferation of doctoral degrees (as you point out) more and more centers are addressing this with specific policies.
I am not trying to take away what you have earned, I do respect the work you've done. For me you are like a cleric in a religion I do not practice. I respect the work you do and the effort it took to get there, but I don't subscribe to the basis behind it. Please do not interpret my post otherwise.
- H
ProZackMI said:Can you saw "unauthorized practice of medicine"? That chiro has NO training to do any of those things and is practicing medicine without a license and is violating the state medical licensing law. If I knew his name and your state, I'd report him myself. In Michigan, that's a felony and he'd lose his chiro license. Your family chiro is no hero; he's a menace and a danger to his patients for committing battery and fraud.
ProZackMI said:I work primarily out of a hospital. My girlfriend is a PharmD-MPH. She is always referred to as "doctor" by physicians, patients, nurses, etc. I work with several PhD psychologists in the psych unit. They are all called "doctor". The PsyD LLP is also called "doctor". There are PhD biomed engineering people and PhD med physics people who are called doctor. There are dentists with staff privis here. We have an OD working the low vision clinic who is called "doctor".
ProZackMI said:NO one gets confused. If an introduction is made, it is qualified. "Hello, Mr. Jones, I'm Dr. Smith, the clinical dosing pharmacist here at the coagulation clinic, and I'll be working with Dr. X on monitoring your Coumadin levels..." Or, "Hello, Mrs. Jones, I'm Dr. Smith, a clinical psychologist and I'll be...." A competent professional always introduces him/herself and then qualifies his/her duties/role.
ProZackMI said:Now, the main question is, why would an allo or osteo hospital have a DC on staff? There would be no need or reason for this.
FoughtFyr said:I am not claiming that I know the policies of every institution in the U.S. Nor am I claiming that such policies (concerning the manner in which staff are referred to) exist in every institution. I am saying that I have worked in institutions that have sought to control the manner in which staff address one another as a percieved patient safety issue. And I don't think think such policies are rare. I have worked in 8 institutions to date as a medical student or resident physician in 3 separate U.S. states. Some policy of this type existed in 3 of them (not geographically centered). With the prolifieration of mid-level providers, the expansion of both academic and clinical nursing doctorates, and the push for more allied health (e.g., PTs) to hold doctorates, I would expect more institutions to create such policies. One hospital where I rotated as a medical student did have a serious problem from just this issue. At that time medical students were referred to as "Student Doctor" or often just "Doctor". A code occured and the room (as usual) filled with staff. A near-by physician came to the door and asked "is a doctor present?" A nurse answered "Yes, Dr. X is". The physician left, never realizing Dr. X was, in fact, a medical student. There are times that not differentiating between MD/DOs and other "Doctors" can be confusing. I think the problem directly correlates to the size of the institution (i.e., at the small community hospital everyone likely knows that Dr. X is a Pharm.D.)
All of which is true, but in a crisis, and in a large institution, I contend the issue might (and anecdotally has) arise. And in a crisis there may be little time for introductions. BTW - you apparently have quite sophisticated patients. Most of mine seem to assign role by gender (i.e., all women are nurses and all men doctors) despite repeated explanations and introductions.
While I agree fully, the truth is, in the era of consumer driven healthcare, some have added DCs to their outpatient clinics.
- H
ProZackMI said:Excellent points. It's my experience that most doctorally-prepared professionals (except MDs/DOs), in a hospital setting, will introduce themselves by their names sans honorifics. "Hello, Mr. Jones, I'm Bob Smith, a clinical pharmacist, and I'll be checking your Coumadin levels today." Or, "I'm Sandy, the physical therapist." Those who insist on using their titles are often insecure or trying to inflate themselves. Nevertheless, I've never heard of an incident at the 4 hospitals where I've worked where a patient was confused, or a nurse or other professional confused a pharmacist, optometrist, or psychologist with a physician -- even at the large hospitals.
ProZackMI said:Why? If someone calls code and needs a "doctor", do you think any sane psychologist or pharmacist or biomed engineer is going to respond?
ProZackMI said:Do you think any DPT is going to answer a call for a patient coding? Is the duty nurse going to mistake a PharmD for an attending? Very doubtful.
ProZackMI said:A competent duty nurse will know the difference between an attending physician, a physician with hospital privis, an intern, a resident, and a lowly medical student. If he/she doesn't, he/she won't be employed long. Confusion arises out of ignorance (mostly on the part of patients) or incompetence.
ProZackMI said:In the scenario you described, the nurse and the medical student were to blame. At my hospital, medical students are the only ones who are expressly forbidden from using a title. They can only use their names with the title "medical student". No student doctor title is allowed. However, other professions with doctoral titles are allowed to use them.
ProZackMI said:The ONLY exception is for NPs who hold doctorates. The title is discouraged unless they are administrators.
PublicHealth said:How about we just refer to FoughtFyr as "God" and everyone else as "lowlife scum?"
FoughtFyr said:Wow, a little below the belt don't you think? I've not attacked anyone personally and am a bit surprised by this as you usually take the high road. I'm sorry if someone stridently defending their opinions (after all, I'm the first to admit these are only my opinions; I try to provide the science behind them when I can) bothers or offends you, I kind of believe it to be the point of forums such as these.
- H
ProZackMI said:Hey, you didn't offend me one bit. You made some very valid points and I apologize for overgeneralizing. I can only report what I have seen through my own eyes and heard through my own ears. I can see why such a restrictive policy is necessary, but I also have not seen it personally.
Thanks for the debate and I concede.
Zack
FoughtFyr said:Zack,
On topic, how are you (as an MD, JD) properly referred to in court? Is it "Doctor" or "Councelor"? Or mix and match for effect?
- H
ProZackMI said:I've been an MD now since 1998 or 1999, so I'm used to be being referred to as "Doctor" most of the time by patients, colleagues, and staff. In law school, the professors use the Socratic method in most first and second year classes. So, on any given day in class, the professor might call out, "Mr. Smith, can you recite the salient facts of Speilberg v. Lucas?" If I was "Mr. Smith", I never, ever corrected the professor, unlike the dentist in class who felt it necessary to say, "That's DOCTOR Smith!"
PublicHealth said:What is it with medical professionals pursuing law?
ProZackMI said:Dissatisfaction with the current state of affairs I suppose. Managed health care, too many FMGs, many factors I suppose. Are you considering going for your JD after your MD and residency?
pinkwank said:dc's in no way receive the education to diagnose and manage illness.
seanjohn said:I have a question for everyone, more specifically those knowledgeable about scope of practice laws for chiropractors.
I live in Canada, and one of my friends is in chiropractic school in first year. He said that in his clincal diagnosis class he's learning how to diagnose ear and eye problems using an opthalmoscope and an otoscope. He's also learning how to use a blood pressure cuff, and a stethoscope. Now, to me that seems like what they're teaching him is beyond the scope of chiropractic practic, which is supposed to deal with musculoskeletal problems.
PublicHealth said:Who said that they did?
PublicHealth said:
PublicHealth said:Most good DCs practice within their scope of practice and treat NMS problems. Lately, many have expanded their practices to include acupuncture, clinical nutrition, and physical rehabilitation.
FoughtFyr said:Umm, acupuncture, clinical nutrition, and physical rehabilitation are not part of chiropractic. Those are best left to the professionals actually trained to provide them.
- H
PublicHealth said:They're within the DC's scope of practice in many US states:
http://www.chiroweb.com/archives/ahcpr/chapter5.htm
I thnk those fundamental tools of diagnosis should basically be used by Chiropractors to know when NOT to treat a medical problem and refer out. Especially BP, just has to be part of the patient record.FoughtFyr said:Oh, I'm not debating that chiropractors have gotten them legally included in their scope, what I am arguing is that none of these modalities are actually part of chiropractic. Palmer did not include any of them is his teachings. It is only now that chiropractic, under fire for a lack of EB practice, has to draw on other modalities, some proven, some not, where their training (much like their "training" in medicine) is generally sub-par when compared to those actually prepared to solely practice those treament modalities. Or are you now trying to caim that in 3 1/3 calendar years the chiropractic student learns all of chiropractic, all of medicine, all of acupunture, all of physical rehab and all of clinical nutrition? Boy, and here I thought medical school was tough. LMFAO.
Heavenly Yours,
- H
FoughtFyr said:Oh, I'm not debating that chiropractors have gotten them legally included in their scope, what I am arguing is that none of these modalities are actually part of chiropractic. Palmer did not include any of them is his teachings. It is only now that chiropractic, under fire for a lack of EB practice, has to draw on other modalities, some proven, some not, where their training (much like their "training" in medicine) is generally sub-par when compared to those actually prepared to solely practice those treament modalities. Or are you now trying to caim that in 3 1/3 calendar years the chiropractic student learns all of chiropractic, all of medicine, all of acupunture, all of physical rehab and all of clinical nutrition? Boy, and here I thought medical school was tough. LMFAO.
Heavenly Yours,
- H
PublicHealth said:Most of this training is done following completion of the DC degree. For example, acupuncture training is available through the International Academy of Medical Acupuncture: http://www.iama.edu/
DCs interested in enhancing their skills in clinical nutrition may pursue a Master's degree in this area: http://www.bridgeport.edu/pages/3246.asp
Diplomate programs are also available for further training in specific subfields of chiropractic, including neurology, orthopedics, sports, rehab, etc.
nomorelaw said:How does a chiro practice neurology?
seanjohn said:I have a question for everyone, more specifically those knowledgeable about scope of practice laws for chiropractors.
I live in Canada, and one of my friends is in chiropractic school in first year. He said that in his clincal diagnosis class he's learning how to diagnose ear and eye problems using an opthalmoscope and an otoscope. He's also learning how to use a blood pressure cuff, and a stethoscope. Now, to me that seems like what they're teaching him is beyond the scope of chiropractic practic, which is supposed to deal with musculoskeletal problems.
Are chiropractors legally allowed to diagnose ear and eye problems and use an opthalmoscope and otoscope? If they are then it seems that they're essentially entitled to diagnose anything that a medical doctor can, and it seems as though their scope of practice is all inclusive to all organ systems, and all parts of the body, and not simply limited to musculoskeletal disorders.
Can anyone clarify this for me?
FoughtFyr said:Oh, I'm not debating that chiropractors have gotten them legally included in their scope, what I am arguing is that none of these modalities are actually part of chiropractic. Palmer did not include any of them is his teachings. It is only now that chiropractic, under fire for a lack of EB practice, has to draw on other modalities, some proven, some not, where their training (much like their "training" in medicine) is generally sub-par when compared to those actually prepared to solely practice those treament modalities. Or are you now trying to caim that in 3 1/3 calendar years the chiropractic student learns all of chiropractic, all of medicine, all of acupunture, all of physical rehab and all of clinical nutrition? Boy, and here I thought medical school was tough. LMFAO.
Heavenly Yours,
- H
PublicHealth said:
ProZackMI said:In the United States, absolutely NOT! This is blatantly illegal. They can use diagnostic instruments in aiding their NMS tx, but to go beyond that is outside the scope of their training and practice. So is nutritional counseling.
611 said:I thnk those fundamental tools of diagnosis should basically be used by Chiropractors to know when NOT to treat a medical problem and refer out. Especially BP, just has to be part of the patient record.
FoughtFyr said:Oh, I'm not debating that chiropractors have gotten them legally included in their scope, what I am arguing is that none of these modalities are actually part of chiropractic. Palmer did not include any of them is his teachings. It is only now that chiropractic, under fire for a lack of EB practice, has to draw on other modalities, some proven, some not, where their training (much like their "training" in medicine) is generally sub-par when compared to those actually prepared to solely practice those treament modalities. Or are you now trying to caim that in 3 1/3 calendar years the chiropractic student learns all of chiropractic, all of medicine, all of acupunture, all of physical rehab and all of clinical nutrition? Boy, and here I thought medical school was tough. LMFAO.
Heavenly Yours,
- H
nebrfan said:Chiropractor.....refer OUT? Why the need?? Obviously, ALL medical problems are, at their root, caused by subluxations impinging on the body's natural life-force and flow of neural information. All you gotta do is crack that subluxation, baby!
seanjohn said:That was brilliant.
Clearly, most of these chiroquackters are "diagnosing" and "treating" (I use those terms VERY loosely, since we all know chiroquackters cannot diagnose, or treat ANYTHING competently, nevermind musculoskeletal problems) things that are way out of their scope of practice, and they're essentially attempting to practice medicine. Just as the early chiroquackters were jailed for practicing medicine without license, so should modern day chiroquackters, since it seems like that's what they're attempting to do.
I'm going to let the government of Ontario know about what these chiroquackters are actually doing in their practice, and hopefully they get jailed for practicing medicine without a license, or better yet they pass legislation to make the practice of chiroquack illegal in this province.