Need some info on Chiropractor things????

[pw079]

Hello, I am interested in attending school to become a chiropractor. could u all plz provide me all the info about the profession that you kno. salary,how easy or hard the schooling is and how to get accepted, daily life, if u like or not , etc... plz tell me nething at all about it..

Thanks

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[Anubis84]

Hello, I am interested in attending school to become a chiropractor. could u all plz provide me all the info about the profession that you kno. salary,how easy or hard the schooling is and how to get accepted, daily life, if u like or not , etc... plz tell me nething at all about it..

Thanks

Don't waste your money and time buying a useless degree that pushes unethical practices. Go to pharmacy school, optometry school, or nursing school. Be a PA. Do anything except chiropractic. You'll regret it.

 

[611]

You may want to check out National University of Health Sciences in Lombard, IL (Chicago). www.nuhs.edu

 

[skiiboy]

Do not listen to Anubis. Chiropractic never has and never will promote unethical practices. There are indeed unethical people and no doubt they will be this way throughout all facets of their life. Chiropractic is an awesome profession. There are currently more chiropractors than all osteopaths in all medical specialties combined. Chiropractic continues to progress by leaps and bounds, not just through political movement but also research. Chiropractic is far and away the number one alternative health profession. In fact to call it alternative is inaccurate as chiropractic is utilized by the public just under medicine and dentistry. Chiropractors are considered physicians in most states. Chiropractic education is very rigorous despite what ignorant people will tell you. Chiropractic is not limited to a specific region of the body like optometry, podiatry and dentistry. The only limitation is with prescription of medication, and this is mostly self imposed. Chiropractors are trained to and must make differential diagnosis on all patients and chiropractors receive alot of training in the interpretation or radiographs, mri's and catscans. As a chiropractor you can be your own boss and make your own hours. Fast Company, a very well respected business periodical just listed Chiropractic as #4, in the top 25 jobs for 2005.

http://www.fastcompany.com/articles/2005/01/top-jobs-main.html#chiro

On average chiropractors do indeed make great incomes. Almost all insurance companies now have chiropractic coverage. Chiropractic is now included in the government plan for physicians who serve in underprivileged areas to receive payment towards their loans. Chiropractors are now in the veterans administration. In fact veteran hospitals all over the country are offering chiropractors jobs with great salaries and benefits.


The difficult part of becoming a chiropractor is that unless you are one of the few chiropractors who are staffed by a hospital you must make it in the private sector. It is true that many chiropractors do not flourish in business, but this is also true of podiatry, optometry etc... There are statistics which show that chiropractors as a whole have a larger default rate than other clinical doctorates but so what... This is probably due a variety of factors, one of which is that there are a large number of chiropractors in the marketplace and managed care environment. I know several chiropractors in my area who have consistantly made several hundred thousand dollars per year for most of their careers.

One of the reasons I love chiropractic so much is because you have discretion as to how you would like to practice. If you want to focus on prediatrics you may, if you want to have a wellness practice that focuses on prevention and overall health you may also do that. If you just want to act as a musculo-skeletal expert and treat people in a few visits and send them off you also can do that. Chiropractic also offers a strong philosophy about health and disease which is unique but at the same time very awesome. Chiropractors have carried the torch that osteopathy gave up a long time ago. Osteopathic medical students who criticize chiropractic do not have the knowledge base to understand that chiropactic has and will continue to stand for the very principles that make osteopathy unique. Instead they criticize because they feel threatened by other health professionals and as such become anti-chiropractic.

If you have the desire to be a chiropractor, you should definitely do more research into the different schools and also make sure you shadow different chiropractors. The more knowledge you have the better. The difference between chiropractic schools can be night and day and can greatly affect how you practice for the rest of your life. I highly recommend New York College of Chiropractic. They now have affiliations with Bethesda Naval Hospital and allow their students to rotate there. In addition they are opening a huge array of opportunities for their graduates.

www.nycc.edu

Also within the next few months, a project to educate the public at large about chiropractic identity education and the benefits of treatment will begin. This is going to be a huge huge campaign, including television, radio, periodicals etc... The leaders of all the different chiropractic schools have finally agreed to agree on a platform for this ad campaign and have hired a top firm in manhattan to bring their message to the public. This is over a year and a half in development. So get ready folks... Here comes chiropractic!!!

 

[nomorelaw]

Do not listen to Anubis. Chiropractic never has and never will promote unethical practices.

You are joking, right? Have you found any subluxations lately?

Chiropractic continues to progress by leaps and bounds, not just through political movement but also research.

That's why they still promote the subluxation theory.

Chiropractors are trained to and must make differential diagnosis on all patients and chiropractors receive alot of training in the interpretation or radiographs, mri's and catscans.

You are joking, right?

On average chiropractors do indeed make great incomes. Almost all insurance companies now have chiropractic coverage. Chiropractic is now included in the government plan for physicians who serve in underprivileged areas to receive payment towards their loans.

Too bad they have the highest default percentages on student loans

If you have the desire to be a chiropractor, you should definitely do more research into the different schools and also make sure you shadow different chiropractors. The more knowledge you have the better. The difference between chiropractic schools can be night and day and can greatly affect how you practice for the rest of your life.

It will ruin your life. Check out http://chirotalk.proboards3.com/index.cgi and www.chiroweb.com.

 

[awdc]

Please refer to my previous posts like this one:
http://forums.studentdoctor.net/showthread.php?p=2585322#post2585322

You should also read the recent IAF report, a study funded by a pro-chiropractic organization. You can find the link here:
http://forums.studentdoctor.net/showthread.php?t=192327

If you use the search function on this forum, I'm sure you'll come across many posts regarding chiropractic. If there are other specific questions, you can post them or PM me. (I was a chiropractor before going to medical school.)

 

[FoughtFyr]

Hello, I am interested in attending school to become a chiropractor. could u all plz provide me all the info about the profession that you kno. salary,how easy or hard the schooling is and how to get accepted, daily life, if u like or not , etc... plz tell me nething at all about it..

Thanks

Try www.chirobase.org

There is a whole section on the "schooling" of chiropractors. Understand that, regardless of what skiiboy might try and tell you, 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).

The 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 residentcy 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.

Last, but not least, again realizing that skiiboy will agrue vehemantly - but remember, he is going to DO school not DC college himself, 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. So entering the chiropractic profession can be a bit more difficult than skiiboy relates. Read this for a bit more skeptical take on chiropractic education: http://quackfiles.blogspot.com/2005/02/why-i-left-chiropractic.html

- H

 

[611]

We could smell these responses coming from a mile away

 

[611]

Is there anyone out there who attended both National University of Health Sciences AND medical school? If so, compare and contrast. Thank you.

 

[skiiboy]

AWDC, while I believe you are being genuine with your feelings about chiropractic, the truth is that your perspective is not based on any experience of being a chiropractor. To put it bluntly, your a chiropractic school dropout who decided to go to medical school in the caribbean and yet continually act as the resident expert on chiropractic. I'm sure that you have valuable information to provide, but unfortunately your profile is the typical profile of people that write on these forums. I am certainly not an expert either, and always clearly state that I am not a chiropractor.

Secondly, FoughtFyr I would expect more of you than to use chirobase as your source for information and arguments against chiropractic. This guy is a chiropractor who never made it in private practice and realized he could make more money by bashing his profession than with helping patients. His site is riddled with flaws and continually criticizes anything and I mean anything other than traditional allopathic medical treatments. No matter what evidence is provided, he will never change his viewpoints. He has teamed up with a psychiatrist who does not practice anymore. Please do me a favor and check out the biography of this psychiatrist.

Also, just so everyone out there knows... a chiropractic subluxation is the equivalent of an osteopathic somatic disfuction or lesion. The concept of such a structrual entity is not only taught in chiropractic schools. Osteopathic schools continue to teach all first and second year students to locate and help fix these osteopathic lesions. In fact the osteopathic manipulative medicine textbook used by most schools is just as dedicated to these principles as any chiropractic textbook. You would be very suprised. I already own my OMM book that I will be using this coming year, as I will be starting in the fall.

You guys really crack me up. Lets take a look at some of the facts shall we. You guys suggest that ot/pt is a better career in terms of reinbursement. Ok first, pt's are absolutely not considered physicians in any states. Secondly, in order to see a patient they must have them referred from a physician. Occupational therapy?? No insurance coverage by any carrier, certainly not considered physicians, can not diagnose any pathology.. musculoskeletal or otherwise. Can not order or interpret x-rays or mri's. Physical therapists are not even aloud to move a joint past its passive range of motion. Physicians assistants??? Again all of the same above, although they do tend to make more money on average than the above professions. However chiropractors on average still make more money than physicians assistants. And there are many chiropractors who make well over $200,000 dollars, physician assistants simply do not have that earning capacity. Chiropractic has been licensed in all fifty states since before I was even born. Chiropractic is mandated to be included by all insurance carriers. Chiropractic is in the veterans adminstration. Chiropractors are now aloud to practice in underserved areas and the government will pay back their tuition just as they would for medical doctors. Chiropractors are staffed on the U.S. olympic team and virtually all major sports teams have chiropractic doctors on staff. Emergency departments have now started to include chiropractic doctors on staff. Also FoughtFyr FYI... Chiropractors in a hospital setting are absolutely referred to as doctors. I know this because I have witnessed it first hand at hospitals here on Long Island.

Chiropractic survived many years without any of these benefits and with a much more vehement opposition by the allopathic machine. It survived for one reason and thats because it contributes to the better health of society. As B.J. Palmer once said "Time always has and always will perpetuated those methods which better serve mankind, chiropractic is no exception."

 

[JohnDO]

Chiropractors in a hospital setting are absolutely referred to as doctors.

Are referred to as or refer to themselves as? A lot of hospitals are starting to set policy on this, it'll be interesting to see where chiropractors fall (though not many hospitals have them on staff).

 

[FoughtFyr]

Also FoughtFyr FYI... Chiropractors in a hospital setting are absolutely referred to as doctors. I know this because I have witnessed it first hand at hospitals here on Long Island.

Chiropractic survived many years without any of these benefits and with a much more vehement opposition by the allopathic machine. It survived for one reason and thats because it contributes to the better health of society. As B.J. Palmer once said "Time always has and always will perpetuated those methods which better serve mankind, chiropractic is no exception."

I never said that at all hospitals they are not referred to as "doctor". I said many and academic. In my experience that is true. I have been a two separate institutions where this is the case and have spoken with my peers in many others. And again, I was referring to the general non-acceptance of the DC as an academic degree.

Chirobase is very well balanced, they post actual studies evidence and open critques of literature. He even posts the responses, as incoherant as they often are, that he recieves from DCs and others. Dr. Barrett has also taken medicine to task over the years, he is a great source.

BTW - if chiropractic is so great, why are you going to DO school?

And chiropractic has survivied because both DD and BJ were geniuses. Not in health care but in the art of public relations!

- H

 

[Science_Guy]

I never said that at all hospitals they are not referred to as "doctor". I said many and academic. In my experience that is true. I have been a two separate institions where this is the case and have spoken with my peers in many others. And again, I was referring to the general non-acceptance of the DC as an academic degree.

Chirobase is very well balanced, they post actual studies evidence and open critques of literature. He even posts the responses, as incoherant as they often are, that he recieves from DCs and others. Dr. Barrett has also taken medicine to task over the years, he is a great source.

BTW - if chiropractic is so great, why are you going to DO school?

And chiropractic has survivied because both DD and BJ were geniuses. Not in health care but in the art of public relations!

- H

Foughtfyr....just out of curiousity. According to the institutional policies where you practice, which doctoral level professionals/researchers/clinicians are referred to as "Doctor" and which ones are not?

I have seen similar institutional policies at academic centers I deal with, and am curious about this. As you stated, academic faculty at the medical/health sciences institutions that I have either been in or worked with do not recognize the DC as an academic track degree, nor do the DCs have privileges.

 

[FoughtFyr]

Foughtfyr....just out of curiousity. According to the institutional policies where you practice, which doctoral level professionals/researchers/clinicians are referred to as "Doctor" and which ones are not?

Where I am, PhDs and ScDs are "doctors", but only in the laboratory areas of the institution. In patient care areas only physicians (regardless of MBBS, DO, MD, or other alphabet soup) are "doctors". DNPs, DScN, DPH, EdD, PharmD, and DPT are not referred to this way to prevent confusion during times of crisis. DCs do not have privledges here, and when I went to a talk by a DC sponsored by our "alternative medicine" department, he was introduced as "Mister". So was a DC who lectured once at my medical school. Now both of these DCs were old enough that it is unlikely they graduated from chiropractic school after the CCE recognition by (then) DHEW (now Department of Education). The "unrecognized" nature of these degrees might explain it, but more likely, the institutions do not recognize the degree at all.

Here is a "pro-chiro" account of the trials and tribulations of chiropractic colleges becoming accredited: http://www.worldchiropracticalliance.org/tcj/1992/jun/jun1992d.htm

My brother-in-law is a straight who was asked by security to stop introducing himself as "doctor" to nursing staff when my grandmother in law was hospitalized. I was in medical school at the time, I had to leave the room I was laughing so hard!

- H

 

[awdc]

AWDC, while I believe you are being genuine with your feelings about chiropractic, the truth is that your perspective is not based on any experience of being a chiropractor. To put it bluntly, your a chiropractic school dropout who decided to go to medical school in the caribbean and yet continually act as the resident expert on chiropractic. I'm sure that you have valuable information to provide, but unfortunately your profile is the typical profile of people that write on these forums. I am certainly not an expert either, and always clearly state that I am not a chiropractor.

Actually I have my D.C. from SCUHS/LACC and practiced a year before going to med school. Heck, I was even active in state and national chiropractic organizations and held officer positions at my school's chapters. Granted, not a lot of experience but I do have some experience. Where did you get the idea that I wasn't a chiropractor? I sometimes state that I used to be a chiropractor in some of my posts regarding chiropractic.

 

[skiiboy]

Well than I apologize AWDC, I must have misread your previous posts. I thought you had said that you decided midway through to discontinue your chiropractic education. By the way, I find it interesting that you attended southern california university of health sciences. This chiropractic school is probably one of the least philosophical schools in the entire country. From what I have heard, chiropractors who graduate from this school tend to act more like physical therapists than chiropractors. Did you feel this way? Did you feel like you received any sort of chiropractic identity/purpose/philosophy from this school at all? Thanks

 

[Anubis84]

Is there anyone out there who attended both National University of Health Sciences AND medical school? If so, compare and contrast. Thank you.

My cat could get into any DC school. It's barely on par with a bachelor's degree. Chiros don't make money unless they push unscientific and unethical practices. They are grossly undertrained and are not true professionals. No medical professional respects chiros. Don't listen to Skiiboy; he has no clue what he's talking about.

 

[Anubis84]

Actually I have my D.C. from SCUHS/LACC and practiced a year before going to med school. Heck, I was even active in state and national chiropractic organizations and held officer positions at my school's chapters. Granted, not a lot of experience but I do have some experience. Where did you get the idea that I wasn't a chiropractor? I sometimes state that I used to be a chiropractor in some of my posts regarding chiropractic.

And the only medical school your DC degree could get you into was Ross? Hehe...your Ross MD coupled with your DC degree will buy you a lucrative practice in some ghetto. What a joke. Couldn't you get into an American medical school? Hell, even a DO school would be better than Ross. WTF!

 

[BackTalk]

My cat could get into any DC school. It's barely on par with a bachelor's degree. Chiros don't make money unless they push unscientific and unethical practices. They are grossly undertrained and are not true professionals. No medical professional respects chiros. Don't listen to Skiiboy; he has no clue what he's talking about.

My cat could get into any DC school.

He may make it to the anatomy lab but that's about it.

It's barely on par with a bachelor's degree.

Chiropractic College is 4 years of post graduate education.

Chiros don't make money unless they push unscientific and unethical practices.

Not true. There are plenty of chiropractors that practice NMS care who are successful. Some even have there own pain clinics where they hire a few MD's and PT's. They make big bucks. I agree there are some guys who practice unproven methods. Most of the DC's I know make more than Family medical practitioners. It is getting harder for all health professions to make a decent living due to managed care.

They are grossly undertrained and are not true professionals.

Really? Please post the article you read that from. We would like to see it.

No medical professional respects chiros.

Many do. In fact, some chiropractors even work in hospitals and have privilages. Some even work in the ER. It is true that there are some that offer no respect like a$$holes like you.

Don't listen to Skiiboy; he has no clue what he's talking about.

You need to see a proctologist as you have your head stuck up your a$$.

 

[skiiboy]

Anubis.... as a 20 year old who still has two years left in undergraduate school, I suggest you not make sweeping ignorant comments like you do, especially about a profession of which you evidently know nothing. Its a waste of your time and ours to see your posts on this matter.

Enuf Said

 

[FoughtFyr]

And the only medical school your DC degree could get you into was Ross? Hehe...your Ross MD coupled with your DC degree will buy you a lucrative practice in some ghetto. What a joke. Couldn't you get into an American medical school? Hell, even a DO school would be better than Ross. WTF!

If you actually intend to become a physician, let me clue you in on a few things...

1. Ad hominum attacks (that is just calling someone stupid or worthless etc.) are not professional. They do no good, ever! Now, feel free to challenge anyone, even their deeply held dogmatic beliefs, but do it politely and do it backed with verifiable facts, not personal insults. That is not science, nor is it productive. Everyone benefits from real discussions, every loses when threads degenerate into personal attacks.

2. Ross graduates attend residencies and join staff at some of the world's most prestigious institutions. There are Ross graduates at the Mayo Clinic, Johns Hopkins, and Mass General. A Ross graduate achieved the highest USMLE Step 1 score of all takers (U.S. and foriegn) several years ago. No, I am not a Ross alumni (I am a U.S. trained MD - University of Illinois, since it seems to matter to you) but I don't think that as an undergrad who has not yet proven they can gain admission to, yet alone graduate from, any medical school, you have room to talk.

3. DOs are also very well accepted by residency programs and medical staffs. In reality, a DO has more options available as they can attend DO residency programs as well as ACGME programs. And again, they train at and work in every major institution in the country.

4. As a former adcom interviewer, I would agree with you that a DC degree will not "get you in" to any medical school. But it won't keep you out either. Many DCs have gone on for their MD degree. And while you are also right that the admission standards for chiropractic colleges are not rigorous, a blind ad hominum attack hardly demonstrates intellect either.

5. There are successful DCs. And there are DCs who are not successful. Individual cases are anecdotal. If you want to debate the utility of the degree in academia, feel free, there are plenty of sources to draw from on both sides. If you want to debate the scientific basis behind chiropractic, again, post and cite sources. If you wish to decry the future of the profession, do so, but again, post something substanitive, otherwise we are all just dumber for having read your post(s).

- H

 

[PublicHealth]

If you actually intend to become a physician, let me clue you in on a few things...

1. Ad hominum attacks (that is just calling someone stupid or worthless etc.) are not professional. They do no good, ever! Now, feel free to challenge anyone, even their deeply held dogmatic beliefs, but do it politely and do it backed with verifiable facts, not personal insults. That is not science, nor is it productive. Everyone benefits from real discussions, every loses when threads degenerate into personal attacks.

2. Ross graduates attend residencies and join staff at some of the world's most prestigious institutions. There are Ross graduates at the Mayo Clinic, Johns Hopkins, and Mass General. A Ross graduate achieved the highest USMLE Step 1 score of all takers (U.S. and foriegn) several years ago. No, I am not a Ross alumni (I am a U.S. trained MD - University of Illinois, since it seems to matter to you) but I don't think that as an undergrad who has not yet proven they can gain admission to, yet alone graduate from, any medical school, you have room to talk.

3. DOs are also very well accepted by residency programs and medical staffs. In reality, a DO has more options available as they can attend DO residency programs as well as ACGME programs. And again, they train at and work in every major institution in the country.

4. As a former adcom interviewer, I would agree with you that a DC degree will not "get you in" to any medical school. But it won't keep you out either. Many DCs have gone on for their MD degree. And while you are also right that the admission standards for chiropractic colleges are not rigorous, a blind ad hominum attack hardly demonstrates intellect.

5. There are successful DCs. And there are DCs who are not successful. Individual cases are anecdotal. If you want to debate the utility of the degree in academia, feel free, there are plenty of sources to draw from on both sides. If you want to debate the scientific basis behind chiropractic, again, post and cite sources. If you wish to decry the future of the profession, do so, but again, post something substanitive, otherwise we are all just dumber for having read your post(s).

- H

Well put, Foughtfyr. We need some mediation around here!

I liked BackTalk's point about DCs pairing up with MDs/DOs, PTs, OTs, and related healthcare professionals with an emphasis on treating NMS conditions. But how common are these types of clinics? A quick google search suggests that there are some, but I'm not sure that this is a trend among chiropractors. In fact, the most recent salary survey conducted by Chiropractic Economics suggests that while the percentage of DCs in group practices or partnerships increased from 21.8% in 2003 to 30.5% in 2004, the figure decreased to 23.0% in 2005. However, it looks like sampling bias may have influenced the latest figure, because 6.5% of survey respondents were associates compared to 0% in both 2003 and 2004. Mean salary for DCs who participated in this survey was $104,363. Here's the link: http://www.chiroeco.com/article/2005/issue6/S&ESurvey05.pdf

 

[awdc]

And the only medical school your DC degree could get you into was Ross? Hehe...your Ross MD coupled with your DC degree will buy you a lucrative practice in some ghetto. What a joke. Couldn't you get into an American medical school? Hell, even a DO school would be better than Ross. WTF!

Despite the obviously self-incriminating remarks as someone who is clearly not a phsycian nor medical student, there is some truth to this. The feeling and vibe I got was that my DC degree didn't really help me (despite doing quite well) but I'm sure it could have hurt. My opinion is that doing well in DC school will most likely not help a subpar undergraduate gpa. U.S. med schools I think just don't know what to make of a DC degree. It's too bad because I think the chiropractic education I received was the ultimate med school preparation (w/ the exception of its cost). Not only in the basic sciences but also in being able to perform histories and physicals and interacting with patients.

 

[PublicHealth]

Some folks at the Mayo Clinic don't seem to buy distraction manipulation of lumbar spine:

J Manipulative Physiol Ther. 2005 May;28(4):266-73.

Distraction manipulation of the lumbar spine: a review of the literature.

Gay RE, Bronfort G, Evans RL.

Mayo Clinic College of Medicine, Rochester, MN, USA. [email protected]

OBJECTIVE: The purpose of this study is to review the literature concerning distraction manipulation of the lumbar spine, particularly regarding physiological effects, clinical efficacy, and safety. DATA SOURCES: A search of the English language literature was conducted using the MEDLINE, Embase, CINAHL, Chiropractic Research Archives Collection, and Manual, Alternative, and Natural Therapies Information System databases. A secondary hand search of bibliographies was completed to identify older or nonindexed literature. DATA SELECTION AND EXTRACTION: Articles were identified, which described the characteristics of distraction manipulation beyond a simple description or the results of treatment with distraction manipulation. Data were extracted on the basis of relevance to the stated objective. DATA SYNTHESIS AND RESULTS: Thirty articles were identified. Three were uncontrolled or pilot studies, 3 were basic science studies, and 6 were case series. Most were case reports. Lumbar distraction manipulation is a nonthrust mechanically assisted manual medicine technique with characteristics of manipulation, mobilization, and traction. It is used for a variety of lumbar conditions and chronic pelvic pain. The primary rationale for its use is on the basis of the biomechanical effects of axial spinal distraction. Little data are available describing the in vivo effect of distraction when used in combination with flexion or other motions. CONCLUSIONS: Despite widespread use, the efficacy of distraction manipulation is not well established. Further research is needed to establish the efficacy and safety of distraction manipulation and to explore biomechanical, neurological, and biochemical events that may be altered by this treatment.

 

[awdc]

Well than I apologize AWDC, I must have misread your previous posts. I thought you had said that you decided midway through to discontinue your chiropractic education. By the way, I find it interesting that you attended southern california university of health sciences. This chiropractic school is probably one of the least philosophical schools in the entire country. From what I have heard, chiropractors who graduate from this school tend to act more like physical therapists than chiropractors. Did you feel this way? Did you feel like you received any sort of chiropractic identity/purpose/philosophy from this school at all? Thanks

Apology accepted and no hard feelings. To answer your questions...

Yes, I think your description of my chiropractic alma mater is quite accurate. It's very much aligned in "philosophy" with other chiro schools such as National and Western States. Of course there was chiropractic philosophy but I'm sure it wasn't emphasized like it is at some other schools. I think the opinions ranged from "not enough philosophy" to "already too much philosophy." Certainly more emphasis on the research and evidence-based care. I felt that there was also a good education in physical rehab... it's just too bad that the clinical semesters didn't reinforce it as well as it should have. It seems that for the most part, philosophy was expressed as seeing the person as a whole and recognizing that there are effects of manipulation not well studied but may be true. Despite the nature of the school, we still had some very philosophically oriented DC's graduating. And yes, since I was very science/evidence-based minded, my practice style was similar to physical therapy.

 

[PublicHealth]

Apology accepted and no hard feelings. To answer your questions...

Yes, I think your description of my chiropractic alma mater is quite accurate. It's very much aligned in "philosophy" with other chiro schools such as National and Western States. Of course there was chiropractic philosophy but I'm sure it wasn't emphasized like it is at some other schools. I think the opinions ranged from "not enough philosophy" to "already too much philosophy." Certainly more emphasis on the research and evidence-based care. I felt that there was also a good education in physical rehab... it's just too bad that the clinical semesters didn't reinforce it as well as it should have. It seems that for the most part, philosophy was expressed as seeing the person as a whole and recognizing that there are effects of manipulation not well studied but may be true. Despite the nature of the school, we still had some very philosophically oriented DC's graduating. And yes, since I was very science/evidence-based minded, my practice style was similar to physical therapy.

I've heard that an increasing proportion of "evidence-based DCs" are essentially practicing physical therapy and using other alternative physiotherapeutics such as acupuncture/acupressure, electrical stimulation, hot/cold packs, and massage to treat NMS issues, and billing for these procedures as if they're performing chiropractic adjustments. Have you found this to be the case in your experience? Also, do you think there is a trend toward more physiotherapy and less spinal manipulation among the "mixer" chiropractors?

Question for everyone: Do you think there is a place for evidence-based chiropractic in US healthcare? Granted, the evidence is not yet available in most instances, but do you think chiropractors -- particularly the mixers -- could be recognized primarily as NMS specialists? I agree that the "primary care physician" designation has got to go, as chiropractors are not properly trained to treat the full range of medical disorders.

 

[truthseeker]

I've heard that an increasing proportion of "evidence-based DCs" are essentially practicing physical therapy and using other alternative physiotherapeutics such as acupuncture/acupressure, electrical stimulation, hot/cold packs, and massage to treat NMS issues, and billing for these procedures as if they're performing chiropractic adjustments. Have you found this to be the case in your experience? Also, do you think there is a trend toward more physiotherapy and less spinal manipulation among the "mixer" chiropractors?

Question for everyone: Do you think there is a place for evidence-based chiropractic in US healthcare? Granted, the evidence is not yet available in most instances, but do you think chiropractors -- particularly the mixers -- could be recognized primarily as NMS specialists? I agree that the "primary care physician" designation has got to go, as chiropractors are not properly trained to treat the full range of medical disorders.

Of course we will accept evidence based practices. ANY practitioner that can prove that their intervention is the best practice for a particular intervention should get the respect and referrals that they deserve. That is without exception in my book. If the DCs can treat back pain better than the PT then they should be getting the patients. However, if things are the same but both are better than nothing, then it becomes a personal preference on the part of the patients.


The reason, IMO, that evidence based DCs are practicing physical therapy like treatment, is that PT interventions have been supported by real research and the DC treatments have not. I don't think the title NMS specialists would be appropriate for a DC any more than it would be for a PT. Plus, you are again assuming that the research, if it ever comes, will support your premise. In my opinion, there is no field that understands biomechanics of motion (or lack of motion) better than a PT.

 

[adamdowannabe]

You guys really crack me up. Lets take a look at some of the facts shall we. You guys suggest that ot/pt is a better career in terms of reinbursement. Ok first, pt's are absolutely not considered physicians in any states. Secondly, in order to see a patient they must have them referred from a physician. Occupational therapy?? No insurance coverage by any carrier, certainly not considered physicians, can not diagnose any pathology.. musculoskeletal or otherwise. Can not order or interpret x-rays or mri's. Physical therapists are not even aloud to move a joint past its passive range of motion. Physicians assistants??? Again all of the same above, although they do tend to make more money on average than the above professions. However chiropractors on average still make more money than physicians assistants. And there are many chiropractors who make well over $200,000 dollars, physician assistants simply do not have that earning capacity. ."

SkiiBoy, just to inform you, don't blanket the PA in with OT,PT, etc........ PA's have all the same practice rights as their physician supervisors, except the ability to be the #1 man in the OR (although I have heard of many cases where the surgeon has their PA colleague do most the cutting, and they treat it like a resident/attending relationship in the OR) PA's can order and read all diagnostics (some states require final approval on pictures by a radiologist, but then again it seems many hospitals require all films be reviewed by a staff radio no matter who reads it initially)

PA's can have a high earning potential, depends what they want to do. If a PA gets a job, and does repetitive, high earning tasks, and has a good contract, the sky is the limit, some PA's negotiate for 40-60% of what they can bill for.... they create 500,000K worth of billable revenue...you do the math!) Although this leads to PA's becoming more like physicians (faster turnover, more procedures=$$$)

And it's not physcians assitants, it's physician assistant (no ownership by the physician of the PA exists,) just a little trivial aspect to the title.

Oh yeah, recheck you facts about insurance coverage of OT, it's carried heavily, every major stroke and head trauma is going to get some OT, usually inpatient, and it's covered.

Chiropractors, are not physicians, they haven't been, they never will be. They spend an ass load of schooling, to practice some very obscure medicine. With a background in massage therapy and physical therapy, I have yet to meet a DC who attempts to fix a problem on a patient, they alwasy just seem to fix the symptoms, and then schedule another appt. DO's use OMM, and then once the work is done, a plan to fix the underlying pathology is created.

If you really want to be a great "holistic" doctor, spend the extra time in school, become a DO and then practice OMM as a specialty (there aren't very many doing it) then at least you can back up your stuff with some good old, tried and true scientific evidence based medicine, with a RX on the side!

 

[FoughtFyr]

Question for everyone: Do you think there is a place for evidence-based chiropractic in US healthcare? Granted, the evidence is not yet available in most instances, but do you think chiropractors -- particularly the mixers -- could be recognized primarily as NMS specialists? I agree that the "primary care physician" designation has got to go, as chiropractors are not properly trained to treat the full range of medical disorders.

I've said it before and I will say it again now. I do see a role for chiropractic in U.S. healthcare. But not at the "primary care physician" or even "advanced practitioner" levels. I believe that neither DCs nor PTs should have direct access. (I honestly think that PTs have largely fought for this right as a response to DCs and if DCs direct access were curtailed, so could be the PTs in the areas where it is currently allowed.) I do believe that chiropractic can fufill a role as physical therapists with a different philosophy than "medical" PTs. I envision this in the same manner that DOs represent a separate (but equal) philosophy to MDs in regard to medical care. Thus, an injured or ill patient, seen and evaluated for significant pathology by an MD/DO, is given a referral for PT or chiropractic care based on their preference. I would even be o.k. with mandating that all physicians must refer based on the patient's (rather than the MD/DOs) choice (with the right, as is currently the case with medical PTs, for the physician to exclude specific therapies for medical reasons). This leaves the patients protected against attempts to treat "beyond the scope" of chiropractic, leaves primary pathology diagnosis in the hands of those most trained in it, but leaves patients with the autonomy to have their NMS complaints addressed as they wish. Additionally, market forces will drive the two professions to a more amiable co-existence. MD/DOs will be made to utilize DC services when their patients request them, and DCs will be forced to back off the most ridiculous of their claims (e.g., anti-vaccination, floridization, ability to cure cancer etc.) to maintain good relationships with MD/DOs in order to get their DC referrals. And this would allow decent expansion of the ED chiropractor concept - which, believe it or not, I am not against as long as PTs are also made available in the ED to patients who prefer that methodology.

- H

 

[BackTalk]

SkiiBoy, just to inform you, don't blanket the PA in with OT,PT, etc........ PA's have all the same practice rights as their physician supervisors, except the ability to be the #1 man in the OR (although I have heard of many cases where the surgeon has their PA colleague do most the cutting, and they treat it like a resident/attending relationship in the OR) PA's can order and read all diagnostics (some states require final approval on pictures by a radiologist, but then again it seems many hospitals require all films be reviewed by a staff radio no matter who reads it initially)

PA's can have a high earning potential, depends what they want to do. If a PA gets a job, and does repetitive, high earning tasks, and has a good contract, the sky is the limit, some PA's negotiate for 40-60% of what they can bill for.... they create 500,000K worth of billable revenue...you do the math!) Although this leads to PA's becoming more like physicians (faster turnover, more procedures=$$$)

And it's not physcians assitants, it's physician assistant (no ownership by the physician of the PA exists,) just a little trivial aspect to the title.

Oh yeah, recheck you facts about insurance coverage of OT, it's carried heavily, every major stroke and head trauma is going to get some OT, usually inpatient, and it's covered.

Chiropractors, are not physicians, they haven't been, they never will be. They spend an ass load of schooling, to practice some very obscure medicine. With a background in massage therapy and physical therapy, I have yet to meet a DC who attempts to fix a problem on a patient, they alwasy just seem to fix the symptoms, and then schedule another appt. DO's use OMM, and then once the work is done, a plan to fix the underlying pathology is created.

If you really want to be a great "holistic" doctor, spend the extra time in school, become a DO and then practice OMM as a specialty (there aren't very many doing it) then at least you can back up your stuff with some good old, tried and true scientific evidence based medicine, with a RX on the side!

Chiropractors, are not physicians, they haven't been, they never will be.

The same can be said for physician assistants. They are an assistant, not a doctor. I would imagine a PA makes a decent living. The thing is you are under control of the physician and or hospital. They control what you make. You say 60% of $500000 which is $300000. You are telling us we can go to PA school for 2 years and make more than most medical doctors? I doubt that.

They spend an ass load of schooling, to practice some very obscure medicine. With a background in massage therapy and physical therapy, I have yet to meet a DC who attempts to fix a problem on a patient, they alwasy just seem to fix the symptoms, and then schedule another appt. DO's use OMM, and then once the work is done, a plan to fix the underlying pathology is created.

Thank you for acknowledging the "ass load" of schooling. Again, as so frequently I find on this board, you have no clue what chiropractic education entails. "A background in physical therapy and massage therapy"? Again, clueless. Our goals are to correct the problem, not treat the symptoms. I guess you feel you can fix disc protrusion in one or two visits. If you can, I would sure like to know how you do it.

If you really want to be a great "holistic" doctor, spend the extra time in school, become a DO and then practice OMM as a specialty (there aren't very many doing it) then at least you can back up your stuff with some good old, tried and true scientific evidence based medicine, with a RX on the side!

Manipulation is manipulation, do you do something different that makes yours "true scientific evidence based medicine". When a DO moves a joint, is there some sort of magic that happens that doesn't happen when a chiropractor does it? Come on. I agree that if you want RX to go with manipulation than DO is the way to go.

 

[FoughtFyr]

Chiropractors, are not physicians, they haven't been, they never will be.

The same can be said for physician assistants. They are an assistant, not a doctor. I would imagine a PA makes a decent living. The thing is you are under control of the physician and or hospital. They control what you make. You say 60% of $500000 which is $300000. You are telling us we can go to PA school for 2 years and make more than most medical doctors? I doubt that.

I agree, but it is not as simple as you make it either. There are PAs who work for physician groups, specifically surgeons, who do make a ton of money. Some do make more than primary care physician MDs. It is a marketplace issue. A cardiac surgeon can do many more open heart procedures if a PA is caring for all of his/her (the surgeon's) patients on the floor. I know a PA personally who works with a cardiac surgeon who makes $170,000. There are PCPs that make less. In short, PAs are not only employed by hospitals, thus, much more money can be made than you might assume.

They spend an ass load of schooling, to practice some very obscure medicine. With a background in massage therapy and physical therapy, I have yet to meet a DC who attempts to fix a problem on a patient, they alwasy just seem to fix the symptoms, and then schedule another appt. DO's use OMM, and then once the work is done, a plan to fix the underlying pathology is created.

Thank you for acknowledging the "ass load" of schooling. Again, as so frequently I find on this board, you have no clue what chiropractic education entails. "A background in physical therapy and massage therapy"? Again, clueless. Our goals are to correct the problem, not treat the symptoms. I guess you feel you can fix disc protrusion in one or two visits. If you can, I would sure like to know how you do it.

O.k., but please acknowledge three simple facts. First, there is a legitimate question as to a chiropractor's ability to diagnose the problem. If you can't find it, you can't fix it. Second, chiropractic is not the appropriate treatment for all conditions, but there are a not so small minority of DCs who believe it is. Lastly, there are straight chiropractors who have no interest in diagnosing pathology. By straight belief, correction of all spinal subluxation will allow the body to heal itself from any condition. Therefore, diagnosis is less important than is returning "proper" nerve flow by reduction of subluxations to allow innate to clear up any problems - diagnosed or not.

If you really want to be a great "holistic" doctor, spend the extra time in school, become a DO and then practice OMM as a specialty (there aren't very many doing it) then at least you can back up your stuff with some good old, tried and true scientific evidence based medicine, with a RX on the side!

Ahh, yes, a "holistic" doctor. Can't possibly be an MD. Yes, I am just a drug company *****. I do not think, or care about my patient, their environment, their overall health beyond what they present to me. Basically, I'm a paternalistic a$$hole! Please. What is it you are so convinced that only a DO does to make them "holistic" compared to MDs? OMM? Having worked with quite a few DOs, the only time I have seen OMM used was to flirt with nurses. There is no difference. Some physicians, both MD and DO, acknowledge the entire person as an entity and health as a spectrum, not merely the absence of symptoms. Others treat diseases only. It is not the title but the practice that counts.

Manipulation is manipulation, do you do something different that makes yours "true scientific evidence based medicine". When a DO moves a joint, is there some sort of magic that happens that doesn't happen when a chiropractor does it? Come on. I agree that if you want RX to go with manipulation than DO is the way to go.

I couldn't agree more. There is no more scientific support for empiric OMM than there is for chiropractic. I guess that is why so few DOs use it regularly.

- H

 

[PublicHealth]

There is no more scientific support for empiric OMM than there is for chiropractic. I guess that is why so few DOs use it regularly

Or is it that DOs are "MD wannabes" who have zero interest in manipulative therapies? Different means, same end. Any data on this?

 

[JohnDO]

Or is it that DOs are "MD wannabes" who have zero interest in manipulative therapies? Different means, same end. Any data on this?

I can never speak for all of us, but most people do not chose DO school soley because of the OMM component. For some, it's location, for others it's the strong emphasis on primary care. Still others chose DO school because of family tradition. DO schools are also very attractive for nontraditional applicants. A few chose DO school soley for the OMM. Some chose DO school because they didn't have the stats for MD school (or had a streak of bad luck during the application cycle). Nonetheless, it's not as simple as being "MD-Wannabes". Don't paint us with a broad brush.

 

[BackTalk]

I agree, but it is not as simple as you make it either. There are PAs who work for physician groups, specifically surgeons, who do make a ton of money. Some do make more than primary care physician MDs. It is a marketplace issue. A cardiac surgeon can do many more open heart procedures if a PA is caring for all of his/her (the surgeon's) patients on the floor. I know a PA personally who works with a cardiac surgeon who makes $170,000. There are PCPs that make less. In short, PAs are not only employed by hospitals, thus, much more money can be made than you might assume.



O.k., but please acknowledge three simple facts. First, there is a legitimate question as to a chiropractor's ability to diagnose the problem. If you can't find it, you can't fix it. Second, chiropractic is not the appropriate treatment for all conditions, but there are a not so small minority of DCs who believe it is. Lastly, there are straight chiropractors who have no interest in diagnosing pathology. By straight belief, correction of all spinal subluxation will allow the body to heal itself from any condition. Therefore, diagnosis is less important than is returning "proper" nerve flow by reduction of subluxations to allow innate to clear up any problems - diagnosed or not.



Ahh, yes, a "holistic" doctor. Can't possibly be an MD. Yes, I am just a drug company *****. I do not think, or care about my patient, their environment, their overall health beyond what they present to me. Basically, I'm a paternalistic a$$hole! Please. What is it you are so convinced that only a DO does to make them "holistic" compared to MDs? OMM? Having worked with quite a few DOs, the only time I have seen OMM used was to flirt with nurses. There is no difference. Some physicians, both MD and DO, acknowledge the entire person as an entity and health as a spectrum, not merely the absence of symptoms. Others treat diseases only. It is not the title but the practice that counts.



I couldn't agree more. There is no more scientific support for empiric OMM than there is for chiropractic. I guess that is why so few DOs use it regularly.

- H

O.k., but please acknowledge three simple facts. First, there is a legitimate question as to a chiropractor's ability to diagnose the problem. If you can't find it, you can't fix it.

True. You say "If you can't find it, you can't fix It." what is it you feel we can't find? We can find subluxations and fix those

Second, chiropractic is not the appropriate treatment for all conditions, but there are a not so small minority of DCs who believe it is.

True. We have been through this before and I totally agree with you.

Lastly, there are straight chiropractors who have no interest in diagnosing pathology. By straight belief, correction of all spinal subluxation will allow the body to heal itself from any condition. Therefore, diagnosis is less important than is returning "proper" nerve flow by reduction of subluxations to allow innate to clear up any problems - diagnosed or not.

Again true. What I was trying to say was something like this.....if we have a patient with a disc bulge or protrusion our goal is to put it back where it belongs and take the pressure off the nerves involved. We then would have the patient do rehab to stabilize the area and decrease the chances of a reoccurrence. Now with medicine many times pain medication is prescribed, which does nothing but treat symptoms. When the medication wears off the problem still exists. Some times anti-inflammatory medication is given, which at least helps with inflammation. The thing is inflammation returns when the medication wears off because the nerve is still being irritated by the disc. Now surgery can fix this problem with a microdiscectomy or using heat to shrink the disc but many times this can cause other problems. At least this is an attempt in this situation to address the cause rather then just treating the symptoms.

 

[lawguil]

Again true. What I was trying to say was something like this.....if we have a patient with a disc bulge or protrusion our goal is to put it back where it belongs and take the pressure off the nerves involved. We then would have the patient do rehab to stabilize the area and decrease the chances of a reoccurrence. Now with medicine many times pain medication is prescribed, which does nothing but treat symptoms. When the medication wears off the problem still exists. Some times anti-inflammatory medication is given, which at least helps with inflammation. The thing is inflammation returns when the medication wears off because the nerve is still being irritated by the disc. Now surgery can fix this problem with a microdiscectomy or using heat to shrink the disc but many times this can cause other problems. At least this is an attempt in this situation to address the cause rather then just treating the symptoms.

Sounds something like what a PT would do!- Right? The question that pops in my mind is does the manipulation have the potential to cause more problems or "irritate the nerve even more". Sounds more like a hypothesis than evidence based medicine. I guess your point is that surgery has its own risks, but doesn't chiropractic have its own risks as well? Apparently there is no reasonable research to support this and you can offer no control in a clinical setting. It's strictly patient number 12 saying I feel better/worse, however would they feel this way without treatment.

The difference I see with DC vs PT = movement/motion/mechanics and STRENGTH & ENDURANCE - and correcting motions with clinical significance and the deconditioning of a patient. If your hammys are tight, PT's stretch the hammys, if the hip flexors & ITB is tight, a PT will treat it, if the abs are weak and you have some lordosis and ant. pelvic tilt, they'll strengthen the abs/glutes/quad lumborum ect., if you have a positive pec contracture test, it's time to try and open up the chest wall. If you present poor foot mechanics, they'll craft a pair of orthodics for the patient to address issues of the lower kinetic chain that ultimately affect pelvic and spinal alignment. Treating a disk protrusion, the PT will provide manual treatment for hypo mobility and spasm/ muscle tone imbalances/ and mobilization so that we don't further irritate the condition with a violent thrust of energy. It’s more about treating the problem of why the disk is out in the first place rather than just treating the fact that it's protruding. The PT will evaluate mechanical and soft tissue dysfunction first and treat the findings all with consideration of the findings from other practitioners and lab/x-ray/MRI/scans. Surely the PT will require a number of visits, but a PT session usually lasts 45 minutes or longer when you have to do manual therapy, exercises and aerobic conditioning, modalities, and education about home exercises programs. It's about treating the "whole" person literally, not just in a holistic alternative sense! Perhaps NMS chiropractors do this as well, spending an average of 60 minutes or longer on each patient (time in the waiting room doesn't count) performing stretches, traction, mobilization, doing exercises including rhythmic stabs, isometrics, isotonic, focusing on position proper techniques and therapeutic methods of core stabilization, modalities, and temporary and permanent bracing/support. I would be interested to hear how much time the DC spends working with patients doing exercises and evaluating NMS dysfunction outside of the spine? L.

 

[San_Juan_Sun]

O.k., but please acknowledge three simple facts. First, there is a legitimate question as to a chiropractor's ability to diagnose the problem. If you can't find it, you can't fix it.

True. You say "If you can't find it, you can't fix It." what is it you feel we can't find? We can find subluxations and fix those

In all seriousness, do chiros really fix these subluxations? I freely admit that I'm as uninitiated as the next guy in reagrds to chiro. But it seems to me that a large chunk of chiro business is treatment of chronic problems performed 2-3 times a week... for years on end. That isn't treatment, it's a scam.

Of course, I reserve some judgment because I obviously don't know the ins-and-outs of the chiro business. But no matter what side of the fence you sit on, until chiros recieve effective oversight from state and national bodies, practice EB treatment (note that I did not say EBM) and follow a fully codified scope of practice, they'll continue to struggle in terms of major public acceptance.

This is what the DOs had to do, and it's worked. For the life of me, I can't understand my osteopathic brethren who want to return to the days of "lightning bone setting". Do they want to end up like chiros? Anyway, I'm getting a bit off topic. Best wishes to everybody.

 

[BackTalk]

In all seriousness, do chiros really fix these subluxations?

All depends on what the chiropractor thinks or rather believes what a subluxation is. I look at a chiropractic vertebral subluxation as an area of joint restriction or altered mechanics secondary to lets say degenerative joint disease. I don't believe all the innate flow and nerve interference hoopla. I wish it were true that subluxation cause nerve interference but I've never seen any valid proof. My remark was intended as a joke.

I freely admit that I'm as uninitiated as the next guy in reagrds to chiro. But it seems to me that a large chunk of chiro business is treatment of chronic problems performed 2-3 times a week... for years on end. That isn't treatment, it's a scam.

Well some of it is or can be a scam. When a patient has a chronic condition there usually is no cure. Pain returns and usually the patient will come in once per month. I have patients who come in twice a month. We do not require anyone to come in for maintenance care. That's their decision. I have patients who need chiropractic care 1X per month not because I say they do, it's because they say they do.

When a patient initially comes to me for care we treat them 3X a week for 3-4 weeks and then re-evaluate. I'm not a miracle worker. It takes time for some of these chronic and acute patients to begin experiencing relief and regain function. Most patients who have a mild problem such as "I slept on it funny" I will see 1-3 times and they're done.

Now the scams are these guys who sell year care plans. That is a scam. We don't know how long it will take for a patient's condition to resolve. The thing is if you have a mild back ache or a severe back problem, the treatment is always one year. It a practice management tactic and I would tell anyone to avoid this type of chiropractor. They are interested in money and not truly helping the patient.

Of course, I reserve some judgment because I obviously don't know the ins-and-outs of the chiro business. But no matter what side of the fence you sit on, until chiros recieve effective oversight from state and national bodies, practice EB treatment (note that I did not say EBM) and follow a fully codified scope of practice, they'll continue to struggle in terms of major public acceptance.

Well I agree with most of what you send. Chiropractic has had these issues for a long long time and the profession still exists. Despite all the issues that go on, I believe chiropractic is becoming more and more popular.

This is what the DOs had to do, and it's worked. For the life of me, I can't understand my osteopathic brethren who want to return to the days of "lightning bone setting". Do they want to end up like chiros? Anyway, I'm getting a bit off topic. Best wishes to everybody.

What do you mean by "want to end up like chiros"?

 

[Docgeorge]

None of my class mates want to lightning bone setters, the ones who are really interested in OMM are leaning toward PM&R.

 

[adamdowannabe]

Be it understood, the opinion most have of chiropractic being "quackery" is based on only a small percentage of DC's who make statements that seem to go against what every DO and MD spent two long years hitting books and 5 or 6 more in training to learn. That the body has issues, and we use science to help solve the problems associated with the issues. In DC where is the science and triple blind studies to prove your practice, last time I took someones word for it, I got sold a rolex that was made in taiwan.

It's kind of like the religious freaks who have been tought all their life that there is a "jesus" he will return, and that you will go to heaven or hell based on his opinion (or however that goes) until it's proven otherwise, PROVEN otherwise, no devout religious person will side with anything else. Prove something in writing and research and studies!

As long as I continue to read articles written by chiropractors, who think they can fix a grade III ankle sprain, by making a spinal adjustment so normal gait is returned, or a chiro who can fix my diabetes, by adjusting my spine to return full nervous transmission to pertinent areas, I will always believe there is some major whack jobs in the world of chiropractic, because these articles get published!!!

Stop letting the whack jobs publish nonsense, and maybe some better medical opinions will be made of the career.

Plus, it's the only medical career (besides quicky glasses shops) that seem to open up practices in strip malls and major shopping areas, more often then in professional and medical offices. There has to be something to it. Granted, the popularity of drop in botox and restyline shops at hair solons is picking up, but thats just greedy derms who run a real practice and want to make another few grand a week doing injections on women while they get a manicure. As soon as legitimate medical practices start opening up in strip malls, then I shall run for the hills and pray to the little purple men who warn me about the spaceship coming.

Oh yeah, I am looking for investors for my new practice I am opening, I call it Vibrapractic, it's just being put on a vibrating bed for a while until your system is so messed up from the motion it can't help by reset itself of all allergies and pain, it's going to be the newest thing, of course it will take 4 years to teach the principles, and total tuition is 115K so, anyone want to become one of the first VD's? (vibrapractic doctors, not veneral diseases)

 

[jesse14]

Backtalk you make me laugh lol. (in a good way). I may have the least experience with chiropractic seeing as how I'm only a 3rd year Kinesiology student. I, however have grown up with chiropractic my entire life in that my father is a DC of 25 years. He makes very good money, practices in his scope, and is always truthfull with his patients. It makes me laugh when i hear about how DC's have horrible training etc...... that's simply just not true. My prof right now for my athletic injuries course is a DO and a well respected one at that. He raves about chiropractic education and how detailed it is. I can't compare it to medical education because except for the basic sciences, they are different entities all to themselves. And to that person to said chirobase or chirotalk is fair and true in what they say.........are you nutts???? This Botnick (sp) guy is such a loser. He must spend a great deal of time and resources just to justify his failure to become a good DC. It's called an inferiority complex and he's got one of the highest order.
Oh yeah, whoever said chiropractic has stood the test of time because of how great a speaker Palmer was is just simply sad. How many chiropractic patients even know who BJ Palmer is?? probably not many, yet they still go to see their chiropractor by choice. NOTHING can last as long as chiropractic has if it's unjustified and yeilds patients disatisfaction. Simply put, chiropractic patients see their DC's because they deem it effective and needed to create total wellness.
That's my 2 cents

 

[Happy613]

Hey,

great debate going on!

I want to know from the chiros out there if they really think that things like peripheral diabetic neuropathy can be treated by adjusting the spine? I don't mean this flippantly.....It might? (I am studying for step 1 right now and it has beome strikingly obvious to me my complete lack of any practical medical knowledge )

I know nothing about chiropractic---except for paradoxically (given the back and forth on this thread)--- a PM&R resident in a top 3 program who swears by his.....

-

p.s. has anyone else ever noticed that the Clinicians forum is by far the most interesting forum on sdn?

 

[awdc]

I want to know from the chiros out there if they really think that things like peripheral diabetic neuropathy can be treated by adjusting the spine

No, I don't believe most DC's think that way.

 

[awdc]

I've heard that an increasing proportion of "evidence-based DCs" are essentially practicing physical therapy and using other alternative physiotherapeutics such as acupuncture/acupressure, electrical stimulation, hot/cold packs, and massage to treat NMS issues, and billing for these procedures as if they're performing chiropractic adjustments. Have you found this to be the case in your experience? Also, do you think there is a trend toward more physiotherapy and less spinal manipulation among the "mixer" chiropractors?

Usually, the adjustments are part of the care so we billed for that. Depending on who's footing the bill (Medicare, insurance, workers' comp, patient, personal injury case, etc.) and their rules, we either bill for the other services, eat up the cost, or have the patient pay for it. Obviously, you can't bill for something you haven't done and I don't think you can substitute one service for another. However, I'm willing to bet that in most cases, a DC will find at least one subluxation/joint dysfunction that he/she will be able to manipulate.

As far as a trend for physiotherapy goes, I'm not too sure if there is or isn't. I know there are a lot of DCs interested in it but part of the problem is being paid for it which can be problematic depending on the patient population.

 

[chirodoc]

Again, I agree with most of what everyone has said. Good and Bad. As far as the earnings of a D.C.? I think in reality it's a farce. Yes, there are some rich D.C.'s earning hundreds of thousands to millions $$$. Most D.C.'s I believe fall around 60-80K if in practice for themselves. Gross earnings and take home are VERY DIFFERENT. Now, that is a decent income for what a D.C. actually "does" because an adjustment is very quick usually less than a minute. The rest of the time (if there is any) is conversational medicine or some preadjustment palpation. You'll need to see alot of patients daily to make some serious bucks, too. I mean A LOT OF PATIENTS.

As an associate D.C. (like me) your screwed-about $40-60K. That sucks...I took a pay cut to just get into chiropractic and cut my teeth and learn as an associate. My employer bills over $500K annually for the work I do.

Most that earn the "big bucks", unfortunately, are NOT practicing the "health concious" cash practice type of business but rather workman's comp. or personal injury. These leave much to be desired as far as job satisfaction and ethics are concerned-I'll leave it at that. As my mother-in-law puts it (she worked for a D.C. 13 years and he's loaded) you go to school for 3 years to get a license to steal (from Insurance). While I won't totally agree with that perspective I'd say it's closer to the truth than I'd like. Overutilization is the rule not the exception.

Do I like being a chiropractor? NO. Do I like chiropractic? Yes. The difference is that joint manipulation, for those who need and benefit from it, is very satisfying and YOU SHOULD BE COMPENSATED for it. However, the truth is you'll starve to death if you don't fall into the typical chiropractor role. Over billing, over utilizing and over stating the benefits of getting an adjustment. That's my observation. I do work with M.D.'s, D.O.'s and veteran D.C.'s in my job for my employer. They are not completely dishonest...just partially. That's just my .02. Everybody sees things differently.

I'd say in general if you REALLY love adjusting people it would make more sense to become a D.O. and call it manipulation. You'll go further and people will automatically give you more credit for doing the same damn thing a chiropractor does even if your not really good at doing it. Being a chiropractor invites these kinds of reactions...read the other threads. Everytime something "D.C." oriented is posted it becomes a flame war.

No respect and disrespect will become a common occurance from ignorant patients, family and peers (allopathic mostly). Last Thanksgiving my wifes grandfather "appeared" to have suffered from a stroke at which time my wife says to me "you've got some medical background go see if you can help him" (he was bolled over the hood of his car outside with all the family going frantic around him-"thanks honey for the vote of confidence"). Out of the blue I get the "here's your sign" comment...what are YOU going to do for him? Adjust him? I should have replied, "No, I've got a pair of jumper cables and he's already by the car...I'll just jump him" In reality, your own family won't think of you as a doctor. Not true in every case but my experience is not just my own but many I've graduated with.

So am I saying don't become a chiropractor? No. Just be VERY SURE YOU UNDERSTAND WHAT IT MEANS. If I had it to do over, I would have chosen differently for various reasons. You will have to bust your A$$ just like every other professional program student to get through it but you will have less security (financially, ethically and morally) with some of the things you MAY SEE (I said "may" so don't flame me or call me names).

 

[FoughtFyr]

Last Thanksgiving my wifes grandfather "appeared" to have suffered from a stroke at which time my wife says to me "you've got some medical background go see if you can help him" (he was bolled over the hood of his car outside with all the family going frantic around him-"thanks honey for the vote of confidence"). Out of the blue I get the "here's your sign" comment...what are YOU going to do for him? Adjust him? I should have replied, "No, I've got a pair of jumper cables and he's already by the car...I'll just jump him" In reality, your own family won't think of you as a doctor. Not true in every case but my experience is not just my own but many I've graduated with.

Not to flame you, or call you names, but I think this is one of the misconceptions that chiropractors all seem to have regarding medical education. Every medical doctor trained at an AAMC or AACOM institution has had to complete clerkships in Medicine, Surgery, OB/Gyn, Family Practice, Psych, and Pediatrics. More than 50% of schools also require an Emergency Medicine clerkship. After that, all licensed physicians must have completed an intern year or a program specific equivalent where most of these clerkships are repeated in some fashion. Why do I bring this up? Because any physician (MD/DO) will have had some training and experience in what to do if someone is having a stroke. They will have seen stroke patients before and will have been intimately involved in their care. This is true if they are a dermatologist or an internist, an OB or a psychiatrist. Chiropractors do not have this level of training, period. You do not have "some medical background" unless you have had additional training outside of chiropractic school. Yes, you took classes from similar texts to a medical student but your profession casts aside most of the conclusions contained within those texts. And those texts are not where a physician becomes qualified to deal with medical problems. It is the clerkships - hands on time with sick patients, and residency training - with more of the same, that "qualifies" physicians. Someone who drops out of medical school after second year is not a physician, nor are you as a chiropractor equipped to handle any medical emergency.

- H

 

[FoughtFyr]

True. You say "If you can't find it, you can't fix It." what is it you feel we can't find? We can find subluxations and fix those

We've had this debate before. I do not feel chiropractors are equipped (read "trained") to find non-NMS pathology sufficently enough to practice as PCPs. I also have grave concerns, based on a large number of mis-diagnoses that I have personally observed by chiros, as to the safety of their practicing at all without MD/DO oversight. Look at my post above (or the posts in other threads where we have had this debate) and realize the width and bredth of MD/DO training. Do MD/DOs miss diagnose? Yes, of course. But if an individual is never trained to recognize a specific disorder, they will miss it 100% of the time. Especially if their contact with sick patients is minimal (as they are unlikely to have come across it in their training to realize the gap in knowledge). If you have been trained in recognizing it, you will still misdiagnose sometimes, but not 100% of the time. And if by some chance you do miss it 100% of the time, QI/QA processes should pick it up. How does QI/QA work for chiropractic again?

Remember, the eyes can not see what the mind does not know.

- H

 

[chirodoc]

So much for agreeing with most of what's been said here. Look I'll be the first to say D.C.'s aren't as clinically competent as most M.D./D.O.'s but your take on it is really skewed. To say I read the same text books in areas of pathology, clinical diagnosis, differential diagnosis...etc. and I was taught a "different" meaning is not accurate at all. I guess some of your information has to come from someone or something very inaccurate because it sure as hell doesn't cover the education or institution I got my degree from.

I agree that some of what your saying is true but you act as though when we studied clinical diagnosis our answer to every situation was "adjust this level" or adjust that (which sounds absurd...and is). Believe me it was never like that...the only way for you to really understand is to go to the school and see for yourself. I can recall many days when the whispered conversations revealed our frustration with how little we "could" do with what we were learning with the "heavy" medical influence. There were no less than 3 M.D.'s who instructed most of my clinical diagnosis, pathology and pharm/tox courses-none ever suggested adjustments as proper care for non-musculoskeletal conditions. Yes, that made some "philosophy" oriented nut jobs angry but that was what I was taught.

As far as the ol' man having a stroke and me not being able (qualified) to diagnose it, I can say my assessment was as accurate as the M.D. who careflighted him to OKC for 3 days of diagnositic tests only to suggest that he had a peptic ulcer and IBS. Interestingly, I've never come across anyone with IBS who suffered unilateral instantaneous upper limb tetany, inablity to speak, brief loss of conciousness with a recent medical history including bilateral carotid endarterectomy less than 6 months ago. Yeah, I guess if I would have deduced peptic ulcer and IBS instead of possible stroke, given the presenting history and state, it would have proven my training was adequate to tell my relatives to rush him to the E.R. I guess the E.R. doc is not trained adequately either since he decided to spend another $20K to fly him to a level 1 hospital for testing for TIA or Ischemic stroke.

I don't know if any of you are Dr.'s of any kind yet...maybe you are but my frustration with chiropractic isn't in what I was taught it's in how much of it I can use. Regardless of the patients complaint my only treatment is joint manipulation and various physiotherapies. It is very limiting, boring and a redundant specialty considering D.O.'s are also trained in manipulation (however they hardly ever do it for any condition). I suppose if they used it more I'd agree that chiropractic would (should) be obsolete. Until then, it will still be around and maligned by every well meaning and IGNORANT detractor who believes "wives tales" that all D.C.'s graduated from accredited professional degree programs are part of a "cult". Maybe 30 years ago a lot of mumbo jumbo took place but I don't think it's accurate to say that now.

Equal to M.D.'s in diagnosis---No. Unable, Untrained to diagnose anything non-NMS---that is just ridiculous. Should D.C.'s be looked at as primary care to evaluate non-NMS conditions? No-unless no M.D./D.O. is available which does happen. But to suggest we are complete idiots is just beneath the level of discussion here-you make it sound like someone would be better off getting a diagnosis from an RN (which by the way suggested my son should just sleep off his head injury which turned out to be a cranial fracture w/subdural hematoma). The bottom line is that I would rather have a very good D.C. evaluate someone than a very bad M.D. Of course the M.D. has had more training but they are human not super-human and some just skated by and are "horrible" and some D.C.'s are frustrated M.D. wannabe's who know 10X more than they will ever use. It's not accurate (let alone fair) to label either profession as overtly competent or incompetent which is the point of disrespect I alluded to earlier in my previous post.

The next time I see someone with "apparent" signs of stroke I'll tell them to drink some Pepto Bismol and take a dump then call me in the morning since it would be "irresponsible" for me to suggest going to the E.R. because I am inadequately trained to evaluate patients for anything but strain/sprain.

No respect..."I tell you, with my doctor, I don't get no respect. I told him, "I've swallowed a bottle of sleeping pills." He told me to have a few drinks and get some rest."

 

[FoughtFyr]

So much for agreeing with most of what's been said here. Look I'll be the first to say D.C.'s aren't as clinically competent as most M.D./D.O.'s but your take on it is really skewed. To say I read the same text books in areas of pathology, clinical diagnosis, differential diagnosis...etc. and I was taught a "different" meaning is not accurate at all.

O.k., show me where in Robbin's Pathology, the Washington Manual of Surgery, or Harrison's Guide to Medicine, or any other medical text for that matter spinal manipulation is suggested as a therapy for any non-NMS condition. Heck, find as a suggested therapy for an NMS condition. Show me where any form of nerve interference or subluxation is listed as the cause of any disease. Sitting in a class, taught by an MD, a DO, a PhD, or a DC does not make you a doctor.

If you read the same texts and arrive at the same differential dx as an MD/DO, how is it that you treat the patient? Pharmacotherapy? No. Surgery? No. Either you refer out, as some chiropractors do, or you treat anyway, like many others. Which chiropractors are which? Who knows!

I guess some of your information has to come from someone or something very inaccurate because it sure as hell doesn't cover the education or institution I got my degree from.

Really? Where did you get your degree? From the CCE website at: http://www.cce-usa.org/Frequently Asked Questions.pdf

"The application of science in chiropractic concerns itself with the relationship between structure, primarily the spine and function, coordinated by the nervous system of the human body, as this relationship may affect the restoration and preservation of health."​

Hmm, I must have missed that chapter in medical school. But let's go on...
(from the same source):

"Further, the application of this science focuses on the inherent ability of the body to heal without the use of drugs or surgery."​

Yep, sounds like you take the same approach I do. No drugs, no surgery. Maybe the institution you got your degree from was not accreditated by the CCE?

I agree that some of what your saying is true but you act as though when we studied clinical diagnosis our answer to every situation was "adjust this level" or adjust that (which sounds absurd...and is). Believe me it was never like that...the only way for you to really understand is to go to the school and see for yourself.

Been to Palmer as a guest. What a joke. Have a family member who is a "straight" chiropractor, what an idiot. I have looked extensively at chiropractic education, albeit with a skeptical view. The fact that many states allow DCs to call themselves "primary care physicians" scares me.

I can recall many days when the whispered conversations revealed our frustration with how little we "could" do with what we were learning with the "heavy" medical influence. There were no less than 3 M.D.'s who instructed most of my clinical diagnosis, pathology and pharm/tox courses-none ever suggested adjustments as proper care for non-musculoskeletal conditions. Yes, that made some "philosophy" oriented nut jobs angry but that was what I was taught.

Fine, I'll take you at your word. But you will admit that there are many chiropractors who practice in a more "straight" manner than you, right? How is a member of the general public to differentiate between a reasonable chiropractor who knows their limits and one who does not?

And, do you really think some classes and practicing on recruited patients gives you enough exposure to pathology to recognize syndromes when you see them? I mean come on, you want us to believe that somehow in three calendar years you absorbed diagnostic skill equal to that which takes an MD/DO a minimum of seven calendar years to obtain and that you were also able to master chiropractic theory and practice at the same time?!?

As far as the ol' man having a stroke and me not being able (qualified) to diagnose it, I can say my assessment was as accurate as the M.D. who careflighted him to OKC for 3 days of diagnositic tests only to suggest that he had a peptic ulcer and IBS. Interestingly, I've never come across anyone with IBS who suffered unilateral instantaneous upper limb tetany, inablity to speak, brief loss of conciousness with a recent medical history including bilateral carotid endarterectomy less than 6 months ago. Yeah, I guess if I would have deduced peptic ulcer and IBS instead of possible stroke, given the presenting history and state, it would have proven my training was adequate to tell my relatives to rush him to the E.R. I guess the E.R. doc is not trained adequately either since he decided to spend another $20K to fly him to a level 1 hospital for testing for TIA or Ischemic stroke.

O.k., first you suggest that the doc thought he had a peptic ulcer and IBS, then you say he was flown out with a presumed dx of CVA. Which is it? And if it was that he was flown and the recieving doc said IBS and peptic ulcer, I would guess that your family is focusing on incidental findings instead of primary diagnosis. I treat a number of my patients for GI issues while assessing their primary complaints.

I don’t know if any of you are Dr.'s of any kind yet...maybe you are

I am a PGY-1 in emergency medicine. I hold an MD as well as an MPH. My undergrad degree is in health policy and education – hence some knowledge of education systems.

but my frustration with chiropractic isn't in what I was taught it's in how much of it I can use. Regardless of the patients complaint my only treatment is joint manipulation and various physiotherapies. It is very limiting, boring and a redundant specialty considering D.O.'s are also trained in manipulation (however they hardly ever do it for any condition). I suppose if they used it more I'd agree that chiropractic would (should) be obsolete. Until then, it will still be around and maligned by every well meaning and IGNORANT detractor who believes "wives tales" that all D.C.'s graduated from accredited professional degree programs are part of a "cult". Maybe 30 years ago a lot of mumbo jumbo took place but I don't think it's accurate to say that now.

I disagree. There is little to no science to support chiropractic. At best, it is as effective, but no more so, than traditional medicine in the treatment of LBP. There is no decent study to define its use in any other conditions. There is no QI/QA protections in place, both the standard of and scope of practice are ill-defined and there are many practitioners who vastly overestimate their skill and training to the detriment of their patients. How is an otherwise naïve health consumer to know if their chiropractor is a mixer, pseudo-mixer, or a straight?

Equal to M.D.'s in diagnosis---No. Unable, Untrained to diagnose anything non-NMS---that is just ridiculous. Should D.C.'s be looked at as primary care to evaluate non-NMS conditions? No-unless no M.D./D.O. is available which does happen.

I didn’t say completely unable or untrained to diagnose anything non-NMS, just not trained enough to do so safely as a matter of routine. And the argument that a DC is “better than nothing” if no MD/DO is available is false. They are worse than nothing in that they can provide a false sense that everything has been “checked out” and no further medical evaluation is needed when that might not be the case. 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. False sense of security at its worst.

But to suggest we are complete idiots is just beneath the level of discussion here-you make it sound like someone would be better off getting a diagnosis from an RN (which by the way suggested my son should just sleep off his head injury which turned out to be a cranial fracture w/subdural hematoma).

No, I would suggest that your son, and anyone else who has health concerns, be evaluated by an MD or DO.

The bottom line is that I would rather have a very good D.C. evaluate someone than a very bad M.D.

Your choice.

Of course the M.D. has had more training but they are human not super-human and some just skated by and are "horrible" and some D.C.'s are frustrated M.D. wannabe's who know 10X more than they will ever use. It's not accurate (let alone fair) to label either profession as overtly competent or incompetent which is the point of disrespect I alluded to earlier in my previous post.

Ahh, but there are huge mechanisms to assess the MD/DO’s skill. QI/QA, practice committees, nursing, M&Ms, case management, etc. What is there for chiropractic?

The next time I see someone with "apparent" signs of stroke I'll tell them to drink some Pepto Bismol and take a dump then call me in the morning since it would be "irresponsible" for me to suggest going to the E.R. because I am inadequately trained to evaluate patients for anything but strain/sprain.

No, it would be irresponsible for you to tell them to call you at all. It does not take an MD or a DC to have enough common sense to refer an emergent patient.

- H

 

[FoughtFyr]

Hey Chirodoc,

Here is a great "case in point" paper.

Archives of Pediatrics & Adolescent Medicine

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

Chiropractic for Children
[The Pediatric Forum]
Turow, Victor D. MD
Division of General Pediatrics, North Shore University Hospital, 865 Northern
Blvd, Great Neck, NY 11020 (Turow).

----------------------------------------------

Outline

REFERENCES

----------------------------------------------

I recently received a telephone call from a concerned mother of an 18-year-old
white man (from an upper-middle-class family) who had not been seen for medical
care in our facility for 3 years. He had been in good health, was about to start
college on a basketball scholarship, and believed that he was too old to see his
pediatricians of many years. When he had begun to complain of lower back pains 2
months earlier, his parents had taken him to their chiropractor. The chiropractor
took x-ray films of the patient's spine and "carefully demonstrated" to him and
his parents a spinal malalignment and hip asymmetry. He prescribed an orthotic
lift and recommended chiropractic treatment 3 times per week. During the 2-month
course of treatment, the back pain aggravated, becoming daily, continuous, and
only mildly relieved with regular ibuprofen use. There was no radiation of pain
and no perceived weakness. The patient had no fever, vomiting, or diarrhea; he
experienced increasing nausea and early satiety. The chiropractor encouraged
patience and recommended several "nutritional supplements," when questioned by
the patient's parents about the relentless pain, the nausea, and perceived
weight loss.

Because we were still this patient's designated primary care provider, his
mother called seeking "another opinion." When I saw the patient the next day, he
appeared gaunt. He had lost 10 kg during a 10-week period. His blood pressure
was 148/100 mm Hg. The results of physical examination were remarkable only for
an appreciable gynecomastia, with no abnormal abdominal or testicular findings.
There was no back tenderness or gross appreciation of scoliosis or limb-length
discrepancy. A urinalysis revealed proteinuria (4+). A computed tomographic scan
of the abdomen (performed with a skeptical agreement of the mother) revealed a
large, necrotic retroperitoneal mass with apparent metastatic lesions in the
kidneys, liver, and lungs. The spine and pelvis were normal. An open biopsy and
histological findings led to a diagnosis of choriocarcinoma, and treatment with
chemotherapy was subsequently instituted.

Three weeks earlier, another patient, a 13-year-old Hispanic boy, was brought by
his father, a retired police officer, to the North Shore University Hospital
Emergency Department, Great Neck, NY. The patient had a 5-day history of
swelling of his right thigh. He had been treated with chiropractic manipulation
for right leg pains during a 6-week period, and his condition was diagnosed as a
spinal malalignment and hip dysplasia. When evaluation performed at the hospital
revealed an aggressive osteosarcoma, the parents attempted to remove the child
from the hospital, citing "distrust of doctors" and faith in the chiropractor. A
Child Protective Services hold was averted when the parents agreed to show the
x-ray films to the chiropractor who did urge hospital treatment.

Increased public interest in alternative health care, even as a primary care,
has had significant medical, social, and political ramifications. A recent
survey [1] revealed that chiropractic was the most popular (36%) form of
alternative medicine used by children. Among the 50 000 licensed chiropractors
in the United States, the minority view advocates chiropractic strictly for
musculoskeletal conditions. Chiropractors, as well as homeopathic physicians,
acupuncturists, naturopaths, faith healers, and other alternative medicine
practitioners, are treating children for otitis media, asthma, various
musculoskeletal disorders, gastrointestinal symptoms (including constipation and
infant colic), enuresis, attention deficit disorders, allergies, and even
epilepsy. [2-6] Many chiropractors offer "comprehensive family health care,"
including checkups and preventive manipulations. Many oppose childhood
immunization, offering spinal adjustment as an alternative means of health
maintenance. [2] Despite the absence of scientific evidence for efficacy of such
treatment in children, many parents, particularly those who themselves are users
of alternative medicine, are likely to try it for their children. [1] Although
claims of efficacy have been mostly anecdotal, claims of serious or fatal
complications with chiropractic manipulation in children have also been poorly
documented. Shafrir and Kaufman [7] reported a case of quadriplegia after
chiropractic manipulation in an infant with congenital torticollis caused by a
spinal cord astrocytoma. In their letter to the editor, Nickerson et al [8]
commented on children seen at the Marshfield Clinic, Marshfield, Wis, who had
chiropractic x-ray films taken and underwent manipulation and/or dietary
therapies for what subsequently was found to be posterior fossa tumor, acute
lymphoblastic leukemia, testicular carcinoma, and neuroblastoma. At our center,
the pediatric oncologists tell of an increasing number of delayed diagnoses of
such serious diseases because parents seek alternative care as primary care for
their children's illnesses. The literature seems to underestimate the magnitude
of this growing problem, as is evidenced by the scarcity of published reports.

Various reasons have been cited as to why families are turning to alternative
medicine. The most commonly cited reason is word of mouth, followed by fear of
drug side effects, chronic medical problems, dissatisfaction with conventional
medicine, and more personalized attention. [1] The allure of "natural cures,"
"without side effects" and with parental active participation in treatment can
be a compelling alternative to daily "body-polluting" medicines, particularly
for a child with chronic disease. [9] The volume and nature of managed care has,
perhaps, contributed to a feeling of alienation between doctor and patient. [1]
Some studies [1,4,10] have suggested that adults with a higher educational level
and higher incomes are more likely to seek alternative therapies. Many such
services and remedies are nonreimbursable. In Canada, a new group has been
formed to represent chiropractors who limit their use of spinal manipulation to
the treatment of back problems and who oppose claims that chiropractic can treat
conditions such as asthma and enuresis. [11]

Insurance companies and legislatures across the United States are debating
reimbursement of such services as chiropractic, even as primary care. Legislation
to allow unlimited chiropractic services under managed care was recently passed
by the New York State legislature (New York State Bill 5972 and New York State
Assembly Bill 8826) and is under review by the governor (Medical Society of New
York, oral communication, September 1996). Alternative health care has become
not only adjunct but primary care for many of our nation's children. Perhaps
greater reporting of adverse events related to alternative care will discourage
our political institutions from supporting public faith in unproved and even
dangerous modes of therapy.

Victor D. Turow, MD

Division of General Pediatrics, North Shore University Hospital, 865 Northern
Blvd, Great Neck, NY 11020

REFERENCES

1. Spigelblatt L, Laine-Ammara G, Pless B, Guyver A. The use of alternative
medicine by children. Pediatrics. 1994;94:811-814. Bibliographic Links

2. Spigelblatt L. Alternative medicine: should it be used by children? Curr
Probl Pediatr. 1995;25:180-188. Bibliographic Links

3. Schmidt M. Childhood Ear Infections: What Every Parent and Physician Should
Know About Prevention, Home Care and Alternative Treatment. Berkeley, Calif:
North Atlantic Books; 1990.

4. Northcott HC, Bachynsky JA. Concurrent utilization of chiropractic,
prescription medicines, non-prescription medicines and alternative health care.
Soc Sci Med. 1993;37:431-435. Bibliographic Links

5. Leboeuf FC, Brown A, Leembruggen K, et al. Chiropractic care of children with
nocturnal enuresis. J Manipulative Physiol Ther. 1991;14:110-115. Bibliographic
Links

6. Klougart N, Nilsson N, Jacobsen J. Infantile colic treated by chiropractors:
a prospective study of 316 cases. J Manipulative Physiol Ther. 1989;12:281-288.
Bibliographic Links

7. Shafrir Y, Kaufman BA. Quadriplegia after chiropractic manipulation in an
infant with congenital torticollis caused by a spinal astrocytoma. J Pediatr.
1992;120:266-269. Bibliographic Links

8. Nickerson HJ, Silberman TL, They FW, et al. Chiropractic manipulation in
children. J Pediatr. 1992;12:172. Bibliographic Links

9. Furnham A, Smith C. Choosing alternative medicine: a comparison of the
beliefs of patients visiting a general practitioner and a homeopath. Soc Sci
Med. 1988;26:685-689. Bibliographic Links

10. Cassileth BR, Lusk EJ, Guerry D, et al. Survival and quality of life among
patients receiving unproven as compared with conventional cancer therapy. N Engl
J Med. 1991;324:1180-1185. Bibliographic Links

11. Lowry F. 'Scientific' chiropractors hope to improve status of chiropractic
within scientific community. Can Med Assoc J. 1995;152:402-404. Ovid Full Text
Bibliographic Links

Alternative Medicine; Chiropractic; Choriocarcinoma; Low Back Pain; OsteosarcomaAccession
Number: 00022363-199705000-00019​

- H

 

[PublicHealth]

According to this 2003 article, about 500 U.S. hospitals have a D.C. on staff. I'd be interested in seeing the full list, and have e-mailed the American Chiropractic Association to ask for it.

http://www.findarticles.com/p/articles/mi_qa3987/is_200310/ai_n9334704

Note that these chiropractors are strictly NMS docs. It seems to me that operating a chiropractic NMS clinic in pain management and rehabilitation settings is a good way to decrease the quackery that plagues the chiropractic profession.

Is it possible for DCs to work collaboratively with MDs/DOs and other healthcare personnel in treating NMS conditions? The VA Hospital System does not think it's a bad idea. I have yet to hear anything negative about DCs being on hospital staffs at VA hospitals. In fact, I have read that some VA DCs are booked solid and in high demand, and that some VA hospitals are hiring additional DCs to assist with the demand on a part-time basis.