Is there a place here for the 250-300k club?

[ampaphb]

PMRMD2B,

If medicine is nothing more than legal drug pushers or dealers, as you so elequently put it, why in heaven's name would you want to join our ranks?

I notice that you have not responded to drusso's mention of the "subluxation concept" as a self-serving invention of the chiropractic profession, as well as that "Most chiropractors are still taught and believe anti-scientific principles about disease, vaccination, preventive medicine, etc. to justify the need for spinal manipulation."

The article I posted was from a chiropractic site, and basically just fleshed out the history of the points drusso already made. It seemed well documented to me. Rather than stooping to the third-grade level of name calling, why not defend your prior field with evidence-based responses?

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[PMRMD2B]

PMRMD2B,

If medicine is nothing more than legal drug pushers or dealers, as you so elequently put it, why in heaven's name would you want to join our ranks?
I didn't say that.. I said some would say.. anyone can say what they want about a profession.. which is evident based on your chiro bashing.

I notice that you have not responded to drusso's mention of the "subluxation concept" as a self-serving invention of the chiropractic profession, as well as that "Most chiropractors are still taught and believe anti-scientific principles about disease, vaccination, preventive medicine, etc. to justify the need for spinal manipulation."
I don't have to defend the profession I WAS in.. I agreed with the points he made. A lot of chiropractors are that way. I wasn't one of them. There are MDs that are wacky as well... like the one in SC that injected pts with H2O2 to cure them of cancer. My practice was based on evidenced based treatments for the conditions I saw.. that is why I had so many MD referrals. These were mostly rehab procedures and manipulations for increased ROM, not to "cure" a subluxation.. I never once used that word in practice. It is funny that MDs talk crap about spinal manipulations.. but when chiros tried to get a law passed so MDs couldn't do it.. they cried and spend a ton of money to keep it in their scope. Just like the ortho in my town.. did a talk at a school on scoliosis and how spinal manipulation didn't help it.. the NEXT week.. a patient came in to me because her insurance ran out because she was seeing the ortho 3x week.. I asked her for what... she said scoliosis... I was interested to see what he did for it.. she said.. he laid me down and cracked my back... 3x a week for 2 months.. and when my insurance was tapped out.. he told me I was better.
I called him out on it the next day and he told me over the phone that he believed it did help problems, but he couldn't tell the public that because they would start going to chiropractors. A month later he started sending his wife to me for headaches, which got better in 4 visits.. after that.. he sent me all his LBP and HA pts. , since he was a surgeon, he said he didn't want to treat these conditions anymore.

It is sad that a chiro can do everything a PMR doc can do, except injections and scripts.

The article I posted was from a chiropractic site, and basically just fleshed out the history of the points drusso already made. It seemed well documented to me. Rather than stooping to the third-grade level of name calling, why not defend your prior field with evidence-based responses?

Again.. I didn't go against the history and some of the wacky idea SOME chiros have. There are wack jobs in every profession. Things change and you can't group them all together. I bet you think all black people love fried chicken and water melon too..

 

[ampaphb]

So if chiropractic spinal manipulation doesn't address subluxation (aka malalignment), but rather "increases ROM", is it your claim that back and neck pain is the result of a decrease in motion at the relevant motion segment? If that is the case, could you possibly provide some peer-reviewed literature to back up that claim?

Also, do you actually believe "It is sad that a chiro can do everything a PMR doc can do, except injections and scripts."?

 

[PainMaster]

This discussion/debate has gotten out of hand. Can you both agree to disagree?
Medical students who are seeking information about the field of PM&R should not limit themselves to a few posts quoting numbers or any other info. It is their responsibility to thoroughly research the I/Os of this field, ideally by finding a mentor who is a well established physiatrist.

If you'd like to argue, resort to PMs.

 

[PMRMD2B]

So if chiropractic spinal manipulation doesn't address subluxation (aka malalignment), but rather "increases ROM", is it your claim that back and neck pain is the result of a decrease in motion at the relevant motion segment? If that is the case, could you possibly provide some peer-reviewed literature to back up that claim?

Also, do you actually believe "It is sad that a chiro can do everything a PMR doc can do, except injections and scripts."?

I didn't treat all neck and back pain with manipulation.. are you just not hearing anything I am saying? I did perform manipulation when it was warranted and seem to be a valuable modality in treating the underlying condition the patient had. Fixation was usually secondary to soft tissue (muscle) problems. All the treatments I performed in my office are the same ones that most PMR docs use everyday. I have been going to PMR seminars for 3 years..I know what is done.. I know PMR physicians and PTs.. and I do the same in office procedures, minus the injections and scripts. So.. by you challenging what I do.. you are saying that what YOU do as a PMR doctor is invalid. Many PTs, PMR docs and other MDs and DOs perform manipulations every single day.. I guess they are all just doing it to hear some joints pop. Why don't you take all this hatred and energy you have and DISPROVE that it has any therapeutic value.. and tell all the world that performs manipulations that they are all idiots and snake oil salesmen? Maybe you should open your eyes... like many MDs have with acupuncture.. and vitamins.. once these were taboo and had no effect.. but.. now they seem to be the best things since slided bread. They weren't taught in med school.. so they must not work.. but all of the sudden.. you get one reputable MD that says it is ok.. only if the MD does it of course.. and it is a craze. Maybe you are the worst of all... a healthcare practitioner who is blind with envy and can't see past his own nose that is high in the air. You..won't seek out alternative treatments for your patients.. because you don't know about it.. therefore it must not be any good. Who is worse my friend.. a chiro who sees 100 people and their treatment really only helps 60.. or and MD, who is too foolish to look outside the box and gives drugs and injections and unecessary treatment to his patients, because he won't try something new?

I don't have to believe the second statement.. it is true that chiros.. with only 4 years of education, not nearly as educated as MD... and no residency.. can perform most day to day tasks that PMR docs perform.

I am done with you.. this is my last post.. you continue to call me out because your ego is hurt that a lowly chiro made more money than you and was more successful, while helping people ethically. You must be tired of people thinking you are a physical therapist and from all the comments people make to you, you feel like you have to assault me. I have done nothing wrong to you, I have only stated my opinion and some facts. I have not been calling you out on you as a physician or a person. You have tried to make this personal.. and I am the wrong one to run up that tree with. You can hide your idenity on here and so it makes you think you have a blank check to badger someone else. I don't have to listen to you.. you are a NO BODY to me.. I know who I am and what I have done.. am doing.. and will do. I don't need your acceptance or approval. Neither does chiropractic or the millions of people who see one every year. These are smart, educated patients.. form poor people up to the rich, famous and even the upper people in our government. I guess they are all just pawns in the silly little chiropractic game.. we fooled them all...
You apparently have some type of inferiority complex about this. I feel sorry for you and I will pray for you.


Good luck my friend.. I really hope you do well in life and accomplish all your goals!

 

[ampaphb]

I didn't treat all neck and back pain with manipulation.. are you just not hearing anything I am saying? I did perform manipulation when it was warranted and seem to be a valuable modality in treating the underlying condition the patient had. Fixation was usually secondary to soft tissue (muscle) problems. All the treatments I performed in my office are the same ones that most PMR docs use everyday. I have been going to PMR seminars for 3 years..I know what is done.. I know PMR physicians and PTs.. and I do the same in office procedures, minus the injections and scripts. So.. by you challenging what I do.. you are saying that what YOU do as a PMR doctor is invalid. Many PTs, PMR docs and other MDs and DOs perform manipulations every single day.. I guess they are all just doing it to hear some joints pop. Why don't you take all this hatred and energy you have and DISPROVE that it has any therapeutic value.. and tell all the world that performs manipulations that they are all idiots and snake oil salesmen? Maybe you should open your eyes... like many MDs have with acupuncture.. and vitamins.. once these were taboo and had no effect.. but.. now they seem to be the best things since slided bread. They weren't taught in med school.. so they must not work.. but all of the sudden.. you get one reputable MD that says it is ok.. only if the MD does it of course.. and it is a craze. Maybe you are the worst of all... a healthcare practitioner who is blind with envy and can't see past his own nose that is high in the air. You..won't seek out alternative treatments for your patients.. because you don't know about it.. therefore it must not be any good. Who is worse my friend.. a chiro who sees 100 people and their treatment really only helps 60.. or and MD, who is too foolish to look outside the box and gives drugs and injections and unecessary treatment to his patients, because he won't try something new?

I don't have to believe the second statement.. it is true that chiros.. with only 4 years of education, not nearly as educated as MD... and no residency.. can perform most day to day tasks that PMR docs perform.

I am done with you.. this is my last post.. you continue to call me out because your ego is hurt that a lowly chiro made more money than you and was more successful, while helping people ethically. You must be tired of people thinking you are a physical therapist and from all the comments people make to you, you feel like you have to assault me. I have done nothing wrong to you, I have only stated my opinion and some facts. I have not been calling you out on you as a physician or a person. You have tried to make this personal.. and I am the wrong one to run up that tree with. You can hide your idenity on here and so it makes you think you have a blank check to badger someone else. I don't have to listen to you.. you are a NO BODY to me.. I know who I am and what I have done.. am doing.. and will do. I don't need your acceptance or approval. Neither does chiropractic or the millions of people who see one every year. These are smart, educated patients.. form poor people up to the rich, famous and even the upper people in our government. I guess they are all just pawns in the silly little chiropractic game.. we fooled them all...
You apparently have some type of inferiority complex about this. I feel sorry for you and I will pray for you.


Good luck my friend.. I really hope you do well in life and accomplish all your goals!

Lot of pent up anger there, for a simple, non-threatening question.

Also, why would anyone waste 8 years of their life just to be able to "do injections and [write] scripts"?

 

[drusso]

See, who says MSK Medicine/Spine Care is non-controversial?

 

[WaterAvatar]

sooo.... any place for the 250-300K club here??.....

I know salary questions are sometimes considered too personal but are any of you PMR-pain docs or Spine docs making 300k a year?? how much do you keep after taxes?

If you don't want to respond publicly.. you can PM me. I'm just curious.

 

[Disciple]

Give it a few years and you should be able to make that much if you do everything right.

It will take a little longer if you want to live in a desirable location.

 

[WaterAvatar]

what do you mean by "doing everything right"?

PM me if you'd like also, because I love "strategizing" for the future..

 

[ampaphb]

The reason this is a silly discussion is that the rules of the game change every year, so you can strategize all you want as a med student, but by th4e time you graduate from fellowship, insurance reimbursement structures will have changed, The Medicare SGR will either have been implemented or fixed, hospital, ASC, and in office facility fees will have dramatically changed, etc. etc. etc. You readjust your strategies every year. Just ask the folks affected by the implementation of the 75% rule, or those who used to do the lions share of their business implanting pumps!

 

[Hemisphere]

hehe this argument is great, i am passing the time on call. ex-chiro vs. pmr.
really though if u ask him to defend "subluxation" i'd like to see you defend "trigger point" or ESI's... then again who needs EBM when u can bill for it anyways...

unfortunatetly the best things in chiro and pmr are not reimbursed, talking to patients, laying hands, actually "thinking"??? rather than churning out procedures. the spiritual remuneration of the act of caring and healing itself. i sounds like such a sap