New Bill Expands Chiropractors Scope of Practice...

[Deecee2DO]

I feel like there is an extremely wide variation in what they're making, and I can never get a good consensus on it haha. My cousin is a Chiro and I think he's bitter I'm in med school. He didn't come to my wedding haha. I could just be reading into it though ... haha. He's a single-office owned chiro and I heard from my family he's doing well for himself, but at the same time no one in my family has ever had anything more than a High School teacher salary.

I scribed for 2 chiros in West Hartford before and they were reeling in cash. That was a very rich area. The head guy drove a BMW. But, he saw ~60 patients a day and was literally sweating by lunch time. He had to take a 2 hour lunch every day. I would never want 200k doing that "Back breaking labor" lol. I'd much rather prefer my work being more cerebral.

I wonder if they pass this bill how it would affect their salaries?

Having been in the field I can tell you that there are more poor chiros than successful ones who make good money. Most of the chiros I know are struggling so bad. They don't get reimbursed for anything, the only way they can make money is if people keep coming back and its way less common to see patients committed to coming in for "wellness" care. Barely anyone is committed to their care plan (usually 3x week for 4 weeks like PT is the "model" chiros use). Like you said there are some chiros that do very well but it is not the norm. There are chiros on every block all over the country and I can tell you that most likely the majority of them are struggling. You need a phenomenal business model, a hard salesman personality, and a multidisciplinary set-up with other real medical providers (MD/DO, NP, PT) who can prescribe, do injections, and practice real medicine that has a much higher likelihood of being reimbursed and to a much larger degree. When I worked as a chiro and I was heading to med school pretty much every chiro I talked to was like "oh man i wish I did that" or "I was going to do that but I just didn't want to do school anymore". They all want to be medical doctors so bad-they want to wear the white coat, the scrubs and play doctor haha dead giveaway when you know someones a chiro is when their "whitecoat" says Dr. So and so without the credentials (probably a chiropractor)

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[drusso]

Having been in the field I can tell you that there are more poor chiros than successful ones who make good money. Most of the chiros I know are struggling so bad. They don't get reimbursed for anything, the only way they can make money is if people keep coming back and its way less common to see patients committed to coming in for "wellness" care. Barely anyone is committed to their care plan (usually 3x week for 4 weeks like PT is the "model" chiros use). Like you said there are some chiros that do very well but it is not the norm. There are chiros on every block all over the country and I can tell you that most likely the majority of them are struggling. You need a phenomenal business model, a hard salesman personality, and a multidisciplinary set-up with other real medical providers (MD/DO, NP, PT) who can prescribe, do injections, and practice real medicine that has a much higher likelihood of being reimbursed and to a much larger degree. When I worked as a chiro and I was heading to med school pretty much every chiro I talked to was like "oh man i wish I did that" or "I was going to do that but I just didn't want to do school anymore". They all want to be medical doctors so bad-they want to wear the white coat, the scrubs and play doctor haha dead giveaway when you know someones a chiro is when their "whitecoat" says Dr. So and so without the credentials (probably a chiropractor)

Why should the government continue to allow student loans for DC programs?

 

[Deecee2DO]

Why should the government continue to allow student loans for DC programs?

They shouldnt. That would end it all. The schools get u hooked make it seem like youll be a doctor with a lot of money and u come out making 40K with 250K in debt. its predatory

 

[KeikoTanaka]

They shouldnt. That would end it all. The schools get u hooked make it seem like youll be a doctor with a lot of money and u come out making 40K with 250K in debt. its predatory

Deecee, since you're now a DO and learning OMM, how does the Chiropractic techniques vary? I've only been to two my whole life (one was my cousin), and scribed for two. They all do the very same cookie cutter things. The ones in West Hartford had really nice tables, however, that performed traction (I really want one) -- But so from what I've seen OMM is literally Chiro on steroids.

But, and I've never billed OMM so I have no idea, how does OMM billing differ from Chiro billing?

Like, If I do Myofascial, Muscle Energy, and HVLA - How would a DO bill that vs if a Chiro does that?

 

[Deecee2DO]

Deecee, since you're now a DO and learning OMM, how does the Chiropractic techniques vary? I've only been to two my whole life (one was my cousin), and scribed for two. They all do the very same cookie cutter things. The ones in West Hartford had really nice tables, however, that performed traction (I really want one) -- But so from what I've seen OMM is literally Chiro on steroids.

But, and I've never billed OMM so I have no idea, how does OMM billing differ from Chiro billing?

Like, If I do Myofascial, Muscle Energy, and HVLA - How would a DO bill that vs if a Chiro does that?

From the time ive been in med school so far as a DO student I can tell you chiro and OMM are exceedingly similar with exception to chapmans points, cranial, listings (T4 N SLRR etc for OMM and chiro is less complicated listing wise), Muscle energy is basically the same thing as ART in chiro (active release technique) just with a different name slapped on it. IMO despite what DOs and DCs say theyre both accomplishing the same “physiological response”. The specificity is overplayed if youre doing HVLA on T5 you arent going to hit just T5 youre going to basically manipulate T4-T7. Chiro and OMM is way overcomplicated. Put motion into the joints (just mobilize the articulatory structures doesnt matter how you do it) and loosen up the muscles and youll provide some relief for mechanical low back pain. Its that simple. You dont need 3 years of chiro school and 4 semesters of OMM to learn that. Difference in billing is chiros wont get reimbursed like DOs because DOs are actual physicians. Id get paid like 40 bucks for HVLA myofascial and an exercise in chiro. As a DO i dont know what they get reimbursed but Ive heard its pretty decent and i am sure its more than 40 bucks lmao. Also medicare will reimburse OMM if im not mistaken but they will not reimburse chiro (they only reimburse spinal HVLA and thats it and it better not be wellness or they are not paying a dime)

 

[KeikoTanaka]

From the time ive been in med school so far as a DO student I can tell you chiro and OMM are exceedingly similar with exception to chapmans points, cranial, listings (T4 N SLRR etc for OMM and chiro is less complicated listing wise), Muscle energy is basically the same thing as ART in chiro (active release technique) just with a different name slapped on it. IMO despite what DOs and DCs say theyre both accomplishing the same “physiological response”. The specificity is overplayed if youre doing HVLA on T5 you arent going to hit just T5 youre going to basically manipulate T4-T7. Chiro and OMM is way overcomplicated. Put motion into the joints (just mobilize the articulatory structures doesnt matter how you do it) and loosen up the muscles and youll provide some relief for mechanical low back pain. Its that simple. You dont need 3 years of chiro school and 4 semesters of OMM to learn that. Difference in billing is chiros wont get reimbursed like DOs because DOs are actual physicians. Id get paid like 40 bucks for HVLA myofascial and an exercise in chiro. As a DO i dont know what they get reimbursed but Ive heard its pretty decent and i am sure its more than 40 bucks lmao. Also medicare will reimburse OMM if im not mistaken but they will not reimburse chiro (they only reimburse spinal HVLA and thats it and it better not be wellness or they are not paying a dime)

If this new bill they're proposing basically tried to equalize OMM billing with Chiro billing to reimburse the full scale of what they do, WHILE VERBALIZING THEIR SCOPE AND LIMITATIONS (I think this is the most important thing - They can't go touting they can heal all things while selling supplements meanwhile Dr's can't have an in-house pharmacy?) I'd almost be okay with that. I don't think they need to classify themselves as physicians to be able to get proper reimbursement for the work they do. They should just be classified as what they are - Chiropractors. I guess, to be fair to them, If one provider does Myofascial, and the other provider does Myofascial, they should be billed the same... But no, they don't need to go around and try to bill for "Dieting advice" and "General healthcare solutions" - that's BS

 

[KeikoTanaka]

If this new bill they're proposing basically tried to equalize OMM billing with Chiro billing to reimburse the full scale of what they do, WHILE VERBALIZING THEIR SCOPE AND LIMITATIONS (I think this is the most important thing - They can't go touting they can heal all things while selling supplements meanwhile Dr's can't have an in-house pharmacy?) I'd almost be okay with that. I don't think they need to classify themselves as physicians to be able to get proper reimbursement for the work they do. They should just be classified as what they are - Chiropractors. I guess, to be fair to them, If one provider does Myofascial, and the other provider does Myofascial, they should be billed the same... But no, they don't need to go around and try to bill for "Dieting advice" and "General healthcare solutions" - that's BS

Although, the government better watch out because as soon as they open up the floodgate for Chiropractic Myofascial to be billed to Medicare - Who's to stop all the Massage Therapists in the country from being like "Hey wait WE'RE PROVIDERS TOO! WE WANT PROPER BILLING AS WELL" lol... oh boy.

 

[NJPAIN]

Chiro in my area own the personal injury world. In this state you go from the accident scene to a lawyer and then a Chiro. They treat, treat, treat until the auto policy is almost exhausted. If there is a high $ policy and some $ is left then they will send to a pain doc and surgeon who will play the game. I know that the personal injury chiros make a mint. One in my area literally lives in a castle on a lake.

 

[Deecee2DO]

If this new bill they're proposing basically tried to equalize OMM billing with Chiro billing to reimburse the full scale of what they do, WHILE VERBALIZING THEIR SCOPE AND LIMITATIONS (I think this is the most important thing - They can't go touting they can heal all things while selling supplements meanwhile Dr's can't have an in-house pharmacy?) I'd almost be okay with that. I don't think they need to classify themselves as physicians to be able to get proper reimbursement for the work they do. They should just be classified as what they are - Chiropractors. I guess, to be fair to them, If one provider does Myofascial, and the other provider does Myofascial, they should be billed the same... But no, they don't need to go around and try to bill for "Dieting advice" and "General healthcare solutions" - that's BS

100% agree with this. If they just stay in their court they should get billed fairly for MSK related OMM type techniques for mechanical back pain.

 

[NOSfan]

In some parts of texas I hear they are already "performing" SCS

Doubt this is true, but please PM any details you may have.

 

[KeikoTanaka]

Chiro in my area own the personal injury world. In this state you go from the accident scene to a lawyer and then a Chiro. They treat, treat, treat until the auto policy is almost exhausted. If there is a high $ policy and some $ is left then they will send to a pain doc and surgeon who will play the game. I know that the personal injury chiros make a mint. One in my area literally lives in a castle on a lake.

Lmao, I mean, hey... if patients are going I guess they're getting some relief... and if they aren't actually paying... why not haha

 

[Deecee2DO]

Lmao, I mean, hey... if patients are going I guess they're getting some relief... and if they aren't actually paying... why not haha

This is actually very true as well-forgot to mention PI (thank you @NJPAIN). If anyone were to do chiro (dont suggest it) but if you did I'd say do PI, as patients are committed to care because they aren't paying and their lawyer is literally on their ass making sure that they don't miss appointments. If you set up the practice model correctly and only do PI (its boring af but it pays better) you can get paid more decently than your run of the mill family chiro practice.

 

[Ducttape]

Lmao, I mean, hey... if patients are going I guess they're getting some relief... and if they aren't actually paying... why not haha

the problem is that patients are sold a bill of goods suggesting that "just one more session or one more week will do it", and they believe it. before they know it, the money is all gone.

there is one particular chiropractic clinic that I have seen several patients that has a regimen - 1/2 hour appointments daily for as long as possible. one patient went 12 weeks (I saw the handwritten scribbled notes.)

in each circumstance, after this time, the No Fault cut them off. the chiropractor immediately discharged them. the patients complained to No Fault, and they were sent to see me for any final options. but It is generally too late as funds have all dried up and try as I might, there is no further no fault treatment, and I'm left seeing a patient that is self-pay or Medicaid.

 

[drusso]

 

[lobelsteve]

Ok. Lets give them an MCAT, USMLE.

 

[KeikoTanaka]

View attachment 281628

lmao how you finding this stuff? Stop looking for it. You know you'll find it. Let them live in their own fantasy land.

Besides, for having only ~300 less hours than them in classroom time, we literally make up for with 16,000 hours of clinical training and constant testing. Which they very purposefully forget to add in this chart. Also, just because they take similar classes doesn't mean the depth is anywhere ours is.

 

[NJPAIN]

View attachment 281628

Outstanding.

I read somewhere, not more than a few years ago, that some Chiropractic schools do not require a completed college degree as a prerequisite for admission. Anyone know if that is still true?

 

[VA Hopeful Dr]

Outstanding.

I read somewhere, not more than a few years ago, that some Chiropractic schools do not require a completed college degree as a prerequisite for admission. Anyone know if that is still true?

Some Med schools technically don't either.

 

[NJPAIN]

Some Med schools technically don't either.

Perhaps if you are part of 6 or 7 year program leading to MD but that’s not the same.

 

[VA Hopeful Dr]

Perhaps if you are part of 6 or 7 year program leading to MD but that’s not the same.

Wrong, a fair number of schools don't require a bachelor's for the general 4 year MD program. I know my school doesn't.

A quick Google search reveals that UVA only requires 90 hours of undergrad. Same with Emory, East Carolina, MCG, and University of Tennessee.

That being said, I'm sure someone with only 90 hours actually being admitted is very rare. But it's not a hard stop at many schools, and not just bottom tier ones.

 

[Ducttape]

that picture is a fascinating work of deception from start to finish.

the chiro is in blue, a more relaxing color, is a man (which if much more often associated with doctor), taller, carrying a clipboard of great medical knowledge, is not directly confronting the viewer, and the additionally column has 4 in chiro and only 3 in medicine side. the graph also appears somewhat disproportionate - if what they claim is true, there should be a 10% difference in size between the 2 figures.

 

[Ferrismonk]

that picture is a fascinating work of deception from start to finish.

the chiro is in blue, a more relaxing color, is a man (which if much more often associated with doctor), taller, carrying a clipboard of great medical knowledge, is not directly confronting the viewer, and the additionally column has 4 in chiro and only 3 in medicine side. the graph also appears somewhat disproportionate - if what they claim is true, there should be a 10% difference in size between the 2 figures.

And I bet if you zoom in really close, the one the left is the only one with "Dr" on his lab coat.

 

[Deecee2DO]

View attachment 281628

Oh man chiros love this picture. All of my old classmates post this all over their practice websites trying to get the public to believe we get the same training. biggest load of crap ive ever seen. Its just not true at all lmao. Only thing I would say is chiro school gross anatomy is actually much harder and more comprehensive than med school gross anatomy but that is the only exception

 

[Deecee2DO]

Outstanding.

I read somewhere, not more than a few years ago, that some Chiropractic schools do not require a completed college degree as a prerequisite for admission. Anyone know if that is still true?

They still dont require one. They dont care about anything but the money you have to give them. Its the carribean MD model

 

[myrandom2003]

Wrong, a fair number of schools don't require a bachelor's for the general 4 year MD program. I know my school doesn't.

A quick Google search reveals that UVA only requires 90 hours of undergrad. Same with Emory, East Carolina, MCG, and University of Tennessee.

That being said, I'm sure someone with only 90 hours actually being admitted is very rare. But it's not a hard stop at many schools, and not just bottom tier ones.

Actually I think just about every medical school has a credits requirement than a degree requirement because most people are applying while in undergrad and don't yet have a degree. No one is checking to see if you actually graduated.

 

[VA Hopeful Dr]

Actually I think just about every medical school has a credits requirement than a degree requirement because most people are applying while in undergrad and don't yet have a degree. No one is checking to see if you actually graduated.

Also not true. I'd say the majority require a bachelor's degree, per my Googling last night.

 

[lobelsteve]

They still dont require one. They dont care about anything but the money you have to give them. Its the carribean MD model

At least SGUSOM is a full 4 years.

3 Yr. Prim. Care Track - Cooper Medical School of Rowan University

 

[Deecee2DO]

lmao how you finding this stuff? Stop looking for it. You know you'll find it. Let them live in their own fantasy land.

Besides, for having only ~300 less hours than them in classroom time, we literally make up for with 16,000 hours of clinical training and constant testing. Which they very purposefully forget to add in this chart. Also, just because they take similar classes doesn't mean the depth is anywhere ours is.

Oh trust me the depth is not even close to MD/DO. Worlds apart. Despite them thinking otherwise

 

[cdmguy]

When I have work comp pts that have seen chiropractors and the notes are available I read those notes and it makes me wish that entire field was disbanded.

Read a chiropractic note and you'll realize what a complete load of BS that field is...Those notes shouldn't be billable IMO. The PE is a joke for someone who puts their hands all over a patient.

As a person with a chiropractic degree I have to agree with this. Student Loan debt is a big political topic right now. Want to reduce defaults? Shut down the non-EBM alt med programs.

I love how DCs pretend they are experts of spinal rehabilitation. If you look at their accreditation guidelines there is no requirement for rehab. My program taught one credit hour for one semester. Yet I am supposed to promote myself as qualified to rehab auto accident victims.

About the chiropractic internist PCP, those are bored grads from the "better" DC programs that teach real differenital diagnosis. Admissions literature emphasizes that they are PCPs yet they have to attend this program? If they were trained to be PCP they shouldn't need it. The internist training is just a few weekends at a hotel sipping orange juice to learn how to prescribe supplements for MI.

Chiropractic Internist: A “specialty” to avoid

The "chiropractic internist" is the creation of an industry association which promotes chiropractors as "primary care physicians." After 300 hours of instruction in a hotel conference room, they claim

sciencebasedmedicine.org

But you can't win with the other camp, the straight chiropractors who "correct nerve interference by straightening spines and removing subluxations." They misdiagnose you, delay your referral for METs, stroke out patients with neck manipulations and tell you about the horrors of flouride and vaccination.

Want to be a pediatrician, we've got you covered. Learn pediatrics in a weekend.

DABCI

This was the website for the American Board of Chiropractic Internists (ABCI) professional certification board and credentialing agency. The content below is from the site's 2008-2009 archived pages.

www.dabci.org

Why the hell would anyone want to visit a medical internist who just covers up symptoms when they could see a chiropractor and fix the true cause of their disease? Charlatans! You all disgust me!

Just think of all the money US health care could save by firing expensive infectious disease specialists and replacing them with chiropractic internists trained in a weekend at the finest chiropractic training money can buy. Can you match their 300 hour training in lots of different specialties? Better get stock in funeral homes.

Live Stream Health Seminars in St Louis | ProHealth Seminars

Live Stream - St. Louis DABCI Seminars NOW LIVE STREAM FROM ST. LOUIS Call for more info This is the old schedule, see the image above or print the registration

prohealthseminars.com

The DABCI approach is generally less about giving something to control symptoms or to give synthetic hormones, and more about finding and correcting the source of the disease.

What is a DABCI?

What is a Chiropractic Internist? | Dr. Jason Nardi

A Chiropractic Internist is the only natural primary care doctors licensed in all 50 states. A chiropractic internist treats a variety of disorders

nardichiropractic.com

What is Functional Shift? | Dr. Jason Nardi

Dr. Jason Nardi is a Board Certified Chiropractic Internist and a Neuro-Structural Chiropractor in Juneau, AK.

nardichiropractic.com