OMT and Chiropractics

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Treybird,

Hey, dude. I congratulate you for wanting to do the Air Force route. However, Chiropractors will never be commissioned as officers because they have no war time duty. Bottom line, you will not change that for a second.

I never said manipulation did not work. It does work but not for every condition that walks through your door.

DCDO,
You are right there are good DCs out there that use rehab and manipulation well.

Also, in addition to my wound care responsibilies. I do spine rehab in acute care. I am the first person to initiate rehab for s/p cervical fusions, Lumbar laminectomies, and microdiskectomies--just to name a few. There are many areas of rehab a DC will never have the opportunity to treat just because of the nature of healthcare. DCs for 99% of hospitals do not do acute s/p surgical rehab.

You are right there are many DCs that may be better than some PTs, however, we as PTs treat a whole alot more medical conditions than DCs. Our training in broader than just spinal manipulation. Now I realize that DCs are moving more into rehab b/c it pays well and for survival purposes, it is a good thing to do.

One quesiton I have always wanted to ask a DC is this, How did Dr. Palmer cure that mans hearing loss by manipulating a spinal segment when hearing is controlled by CN VIII??
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Treybird,

You have so much to learn and I am glad you are coming back from the dark side. Legally you are right, PTs can not diagnose, however, we learn the same orthopedic skills and neurological skills that you do, big guy. It does not suck being a PT in Indiana. Why are you leaving DC if it is so great.

What can a Chiro Diagnose? Subluxation a L4-5 that does not exist. Please tell me what you have diagnoses lately.

Let me tell you what I have caught in the acute care hospital. (1) A rotator cuff tear, not real important except the guy had a stroke and fell. Well, at the time the medical staff was trying to save his life so the cuff tear wasn't so important but I still caught during rehab. (2) A DVT, oh yeah, you did get that medical terminology in DC school. Deep vien thrombosis, pain, swelling in the calf. Important, hell yeah, it can break loose and kill you. (3) One of my patients had multiple falls prior to admission to the hospital. Most recent caused a compression fracture at L2-3. Why was he falling so much. Well, he had a stoke many years ago and his evertors are non functional. Well, foot drop/drag city with multiple falls. His neurosurgeon said it was very important to avoid another fall to prevent permanent paralysis. Oh may friend it was the PT that found this little missed fact. Missed by his DC and MD. So home boy, I found it and got him a AFO (ankle foot orthosis). Guess what, no more falls.

So get off your high rocking horse with your, I can diagnose BS. Bottom line. PTs top to bottom can hold there own and in most cases kick your gluteus maximus, medius, and minimus. Just the facts.
 
FutureMD/DO, I absoultely agree with you that Chiropractic can't cure anything. All it does is align the spine, get the joints moving, and reestablish nerve flow to the organs and muscles they innervate. That's it. It's no more complicated than that. I've never claimed to cure anything and if you went to a DC who claimed he could "cure" anything, run. That's malpractice, pure and simple. I also realize that some spinal cases are an emergency and require surgical treatment. AND, I would not touch a patient after surgery until released by their doctr. I understand my limitations perfectly, but a PT does not. I realize that PT's play a very important role in the healthcare system, as do DC's. That's been my only point through this whole debate. We play an important role as well, and we are qualified to do what we do. If a DC works outside their scope of practice, which are clearly defined by state law, than he is comitting malpractice. Whether you, as a PT, DO, or MD, FEEL that we are is not of concern to me. I don't say that in a mean or negative way.

As for helping Harvey Lillard with his hearing, we all know that the T1 and T2 nerves (of the sympathitic nervous system) control vasodilation in the head region. He didn't adjust CN VIII, he adjust their blood supply.

You never know how far chiros can go in the Air Force. We would probably double-up on some other activity. Who knows.

TB
 
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DCDO, I will be leaving for school in mid-August. I am still waiting to hear from Indiana U. before I make a final decision. I've been accepted to a few DO schools, but IU is my first choice. Where did you do your trainings?? Thanks for the good luck wishes. I'm not looking forward to the long trek ahead, again. I guess the big thing is getting BACK into studying. Oh, and I hate the smell of cadavers.

TB
 
TREYBIRD!! Thank god you are here! He he he, I thought I might get that reaction...it was that whole different paradigm thing you mentioned two pages ago. I am currently at Colorado College of Chiropractic in Denver. It's a great school, but brand spankin new, so it's got it's issues too. Did you ever read Gatterman's texts? Yeah, she's at our school. She's awesome, I love her.
Anyway, whew, look at what I've started! I think it's great. You guys all think you have all the answers and it's great for your patients that you have so much passion! You just need to broaden the ol horizons a bit....
Ummmm, lessee, only a few more things....ah yes, I recently worked for a DC here in Denver, who works with orthopedic spine surgeons at Swedish Medical Center every Thursday, along with his normal practice where he does sports physicals for the high school kids, has a PT within his office, (as well as 2 acupuncturists and 5 massage therapists), has been known to diagnose such off the wall things such as glomerulonephritis (and refering them out), and, oh my god, he's residency trained too! I know there are only a handful of them out there, but residency trained DC's do exist. It's completely optional of course. He is also a fav among the insurance companies for IME's because he DOESN'T run up the bill. (as an example)
And I thought I would point out that Blue Cross/Blue Shield of IL ran a study where they made some select DC's, PCP's. They wanted to know what would happen. Health care costs dropped 40% and patient satisfaction skyrocketed. Look, I know we are our own worst enemy. There are a lot of crazy ideas out there. A lot of crazy literature too. And yes our school's standards are low (which I too hate, but it didn't change my opinion on the profession), but I have noticed they are rising all the time. As for the school I am in, we have two classes/yr and cap the size at 80 students. Diploma factory? That just doesn't match. I was just hoping to try and crack open the door for some new ideas in this allopathic world. Maybe Treybird is right, maybe it's just hopeless. For now. But keep your eyes open, chiro is only getting better, and won't fade away. Look at the research. (About both manipulations and subluxations, which do exist.)And please, I forget who said something about radiology....please take a look at that text I mentioned. It's a really good radiology text!
As for the military...well, we are working on that as well. A bill just passed this fall actually that gives us coverage for Vets. Things will change there too. And I know that our belief and our patients belief in the treatment doesn't constitute "proof", but it doesn't mean that it doesn't work either. It does work. I think a lot of people don't go to chiros because their docs put them down so much! But that's just me.
As for all you PT's, I definitely hit a nerve...for that I apologize. I have never been to PT school. I worked in a PT clinic once, but that was unlike everything you all have mentioned. However, NONE of you have been to chiro school either. You are just repeating what you have heard about chiros. I realize that there is (quite a bit of) friction between the two professions. I really think it's unnecessary to put chiros down when you don't have all the facts. Why would you want to limit chiros scope of practice? Why wouldn't you want all the tools to help your patient, no matter what discipline? Because it'll hurt your practice, that's why. We're good, we're good, but we're not out for acceptance from the allopathic field (although most of us do enjoy working with you...), we are only seeking the satisfaction of our patients.
Treybird, I think that is awesome you wanna go into the AF, good luck! And good luck to all of you too. I was just trying to plant a seed, that's all. :) TTFN
P.S. NOT ALL OF US RUN UP INSURANCE BILLS, CLAIM WE CAN CURE CANCER
 
Anyone else looking for some good radiology? Check out anything written by Russel Erhardt, DC, DACBR. I took his 100 hour post-graduate X-ray seminar series and the guy was awesome. And apparently the medical profession thought so too because he used to teach to medical radiologists on a regular basis. Did anyone say that Chiros shouldn't be radiologists??

Hey, I have an idea. Would any of you PT's like to get adjusted?? Seriously, if you are ever in Ft. Wayne, IN, please stop by my office and we'll take care of you. I'll even light the voodoo candles I keep in my office and make sure the office Pagen priest is present so that nothing goes wrong....ha ha...those silly Chiros. Who do they think they are? :cool:
 
Wow, you guys are in your OWN LITTLE WORLD OF DENIAL aren't you???

I have posted many illegitimate claims and outrageous sayings by chiropractors and yet all I hear is "PT sucks, we work with back surgeons, we rule". Good arguments.

I don't need to go to chiropractic school to be convinced of its poor admission standards or shoddy science requirements and/or teachings! Much similar to the fact I don't need to get a combined PhD/MD degree at Harvard to say that is "challenging". Do you EVEN HAVE ADMISSION REQUIREMENTS for DC programs?? Is there ANY type of self regulation or licensing exam or RE-licensing exam or CME requirments????
Here is an example of the admission standards for DC's...

A survey comparing U.S. chiropractic colleges with five other types of professional schools has found that chiropractic schools had the lowest standards. Publications and telephone inquiries were used to compile information on (a) the percentage of the previous year's entering class with a bachelor's degree, (a) the minimum grade point average (GPA) required for admission, and (c) the average GPA of the previous year's enrollees. The researchers noted that although the degree of undergraduate success may reflect the potential for professional success, further research would be needed to confirm this. The study found:

Type and Number
of Schools,% with
Bachelor's Degree, Avg. Minimum
GPA Required, Avg. GPA of Enrollees
Medical (17)
99.35%
3.16
3.56
Optometry (16)
76.88%
2.55
3.30
Osteopathic (16)
97.00%
3.00
3.26
Dental (15)
66.87%
2.79
3.13
Podiatry (7)
89.40%
2.76
3.06
Chiropractic (16)
42.25%
2.38
2.90

Reference
Doxey TT, Phillips RB. Comparison of entrance requirements for health care professions. Journal of Manipulative and Physiological Therapeutics 20:86-91, 1997.

Ya know, and here is a quote from ONE OF YOUR OWN (very hokey) JOURNALS! Quoted from from Matthew McCoy, D.C., editor of the Journal of Vertebral Subluxation Research, who said (in part):

"Want to know what really makes me mad as hell? We have probably less than 100 full time researchers in the chiropractic profession and we can't even afford to pay them a livable wage. The least we should be able to do is rely on our research journals, foundations and institutions to make sure idiots like this do not work in our profession. Their obvious skewing of data, mining of the literature and political agendas are obvious to anyone with a head just a tad sharper than a bowling ball. . . .

As for DIAGNOSING in Indiana?? Diagnosing what? Secondly, PTs can manipulate in Indiana, I didn't know this until I spoke at the State House, but many of them ARE manipulating. It is just termed a grade 4 mobilization but I saw it, it is the EXACT same thing!
Finally, instead of using POLITICAL means of increasing my health care practice act, I decided to return to school. I suggest that to any Allied Health professional (PT, PA, NP, DC) as apposed to using the law to meet an agenda. I am glad you are doing this Trey. (By the way, it is nearly May, I honestly doubt IU will be able to give you a spot. THey are pretty competitive at this point, but good luck anyway.)
Trey, don't forget I am a PT that is now a DO...I think I know how to manipulate...I'll save the gas to drive elsewhere.
 
I have one question.

That chiropractor person said this...

"How you can even slam chiropractic when half of medicines used today are not properly tested causing patient death from complications is beyond me."

Half of all medicines aren't properly tested? You sure about your figures?
 
No, actually IU is still accepting, but thanks for your typical pearls of wisdom. Fortunately I don't get my self-esteem from PT's. I'll let you know when that acceptance call comes through. Oh, wait, you'll be busy pretending to be a physician. I don't remember anyone I know going to a PT for an adjustment. It's kind of cute how you like to pretend that you PT's can adjust like Chiropractors. It's like watching a little kid pretend to be like his daddy. And I'm sure that all your 1/2 year of DO experience has made you much more competent at adjusting than most Chiros b/c, as you already know, YOU ARE GOD!!!

WishUponAStar: I'm sorry, what did you say the stats were? What are the efficacy and death stats on medicine?? Ok, maybe not 50%, what 25%? even 10%? Hmm, could you campare that to Chiropractic's efficacy and death stats?
 
I LOVE this letter from the Dept of Health & Human Services:

<a href="http://www.worldchiropracticalliance.org/media/hhsletter.htm" target="_blank">http://www.worldchiropracticalliance.org/media/hhsletter.htm</a>

PT's skunked AGAIN.

VA bill passes Senate
Final wording covers subluxation correction

On Dec. 20, 2001, the U.S. Senate voted to approve a bill that would make chiropractic
available through the Veterans Affairs health system. The vote took place days after the
House of Representatives gave its approval of the bill, containing language that permits
chiropractors to provide subluxation correction.

Amazing how the govenrment would offer coverage for a service that, according to the PT's and some DO's, doesn't exist. Must be more evidence of the government wasting our tax dollars on non-entities. Oh, no, it must be that overwhelming political pull that Chiros have over the AMA.

:clap:
 
I LOVE this letter from the Dept of Health & Human Services:

<a href="http://www.worldchiropracticalliance.org/media/hhsletter.htm" target="_blank">http://www.worldchiropracticalliance.org/media/hhsletter.htm</a>

PT's skunked AGAIN.

VA bill passes Senate
Final wording covers subluxation correction

On Dec. 20, 2001, the U.S. Senate voted to approve a bill that would make chiropractic
available through the Veterans Affairs health system. The vote took place days after the
House of Representatives gave its approval of the bill, containing language that permits
chiropractors to provide subluxation correction.

Amazing how the govenrment would offer coverage for a service that, according to the PT's and some DO's, doesn't exist. Must be more evidence of the government wasting our tax dollars on non-entities. Oh, no, it must be that overwhelming political pull that Chiros have over the AMA.

:clap:
 
Let's look at the CHIROPRACTIC DEFINITION OF SUBLUXATION (not the medical definition):

In 1973, Congress authorized payment under Medicare for chiropractic treatment of "subluxations demonstrated by x-rays to exist." In 1972, to enable payment, chiropractors held a consensus conference that redefined "subluxations" to include common findings that others could see. The document, several pages long, described the supposed x-ray manifestations of 18 types of "subluxations," including "flexion malposition," "extension malposition," "lateral flexion malposition," "rotational malposition," "hypomobility" (also called "fixation subluxation"), "hypermobility," "aberrant motion," "altered interosseous spacing," "foraminal occlusion," scoliosis, and several conditions in which "gross displacements" are evident [4]. I have been unable to determine how many billions of dollars chiropractors have received from Medicare since the law took effect.

Some of these terms are fancy names for the minor degenerative changes that occur as people age. The conditions often have nothing to do with a patient's symptoms and are not changed by chiropractic treatment. Some, as acknowledged by the conferees, are not even visible on x-ray films. In 1997, Congress amended the law to permit payment for subluxations diagnosed by other means -- a policy scheduled to take effect on January 1, 2000.

Chiropractors also differ about how to find "subluxations" and where they are located. In addition to seeing them on x-ray films, chiropractors say they can find them by: (a) feeling the spine with their hand, (b) measuring skin temperature near the spine with an instrument, (c) concluding that one of the patient's legs is "functionally" longer than the other, (d) studying the shadows produced by a device that projects a beam of light onto the patient's back, (e) weighing the patient on special scales., and/or (f) detecting "nerve irritation" with a device. Some subluxation-based chiropractors say that subluxations at the top of the spine are the ones that count [A, B] some focus on the bottom of the spine, some work at both ends, and others locate and treat them throughout the spine. Undercover investigations in which many chiropractors have examined the same patient have found that the diagnoses and proposed treatments differed greatly from one practitioner to another.

Subluxation is also a medical term. The medical definition is incomplete or partial dislocation -- a condition, visible on x-ray films, in which the bony surfaces of a joint no longer face each other exactly but remain partially aligned. No such condition can be corrected by chiropractic treatment.

Two years ago, in an attempt to "unify" chiropractic terminology, the Association of Chiropractic Colleges issued the following definition:

A subluxation is a complex of functional and/or structural and or pathological articular changes that compromise neural integrity and may influence organ system and general health.

In 1997, the Foundation for Chiropractic Education and Research issued a pamphlet called "Subluxation: What It Means to You," which states:

What the above means is that a subluxation is a joint problem (whether a problem with the way the joint is functioning, a physical problem with the joint, or a combination of any of these) that affects the function of nerves and therefore affect the body's organs and general health.
In the late 1980s, the Vertebral Subluxation Research Institute (VSRI) was launched by Terry Rondberg, D.C., of Chandler, Arizona. Rondberg is president of the World Chiropractic Alliance (WCA), a group that promotes subluxation-based practice and is president of Chiropractic Benefit Services, a malpractice company that insures subluxation-based chiropractors. He also publishes The Chiropractic Journal (a newspaper for chiropractors), the Journal of Vertebral Subluxation Research and Health Watch (a newsletter that attacks what it considers to be "the dangers and abuses of medical and drug interests."). VSRI taught chiropractors how to recruit "research volunteers" and convert them into lifetime chiropractic patients. Its chiropractor clients were instructed to use telemarketing and other approaches to ask people to volunteer for a nationwide study on spinal conditions. During the first office visit they would be examined and given a brochure -- "The Silent Killer" -- which explains how subluxations can be caused by physical, chemical, and emotional trauma. (The brochure claimed, for example, that food additives, air pollutants, spoiled food, fear, worry, hate, greed, sadness, grief, emotional shock, and severe disappointment can cause muscle spasms that result in subluxations.) During the second visit, they would be advised to have their subluxations treated. TheVSRI program was concluded in 1991 [6]. A subsequent WCA survey found that 65% of members who responded said that their patient education material referred to the vertebral subluxation as the "silent killer."

Wow, that is alot of deep crap.
Anyway, Trey, I was truly saying "good luck", IU is a great school (as I have worked with many of their students) and you should be very proud if you went to medical school there!
 
•••quote:•••Originally posted by Treybird:
•Oh, wait, you'll be busy pretending to be a physician. I don't remember anyone I know going to a PT for an adjustment. It's kind of cute how you like to pretend that you PT's can adjust like Chiropractors. It's like watching a little kid pretend to be like his daddy. And I'm sure that all your 1/2 year of DO experience has made you much more competent at adjusting than most Chiros b/c, as you already know, YOU ARE GOD!!!

WishUponAStar: I'm sorry, what did you say the stats were? What are the efficacy and death stats on medicine?? Ok, maybe not 50%, what 25%? even 10%? Hmm, could you campare that to Chiropractic's efficacy and death stats?•••••I think that it's a little ironic, that a DC (who claims to be a PCP) is jeering at the 4th year med student "playing doctor." Taber's defines a primary care as "Integrated, accessible,health care, provided where the patient first seeks medical assistance, by clinicians, who are responsible for most of a patient's personal health care, including health maintenance, therapy during illnesses, and consultation with specialists." I can not think of one time where I have seen a DC treat a common illness such as CHF, OM, CAD, pneumonia, URTI, UTI, or DM. I have yet to see a DC directly refer a patient to a pulmonologist, a CV surgeon, or a hematologist-oncologist. As a fourth year med student, Clown guy has prescribed more medications, consulted with a larger number of specialists, ordered and interpreted more varied tests, performed more surgery, and treated a wider variety of disease than any DC. (hell, as a third year medical student, I've probably done the same.) If anyone has any performed in a manner similar to a true physician, it's been Clown guy.

Secondly, if you want to criticize the shortcomings of medicine (which you will soon be a part of), you had better have a better alternatve. I would like to see the efficacy of manipulation on any of the above conditions. Antibiotic-resistant TB? What has chiropractic done to remedy this problem? I wonder what the efficacy and mortality rate is for manipulation when used to treat status epilepticus? How about PE? Or a dissecting aorta? How about diffuse ST elevations and PR depressions? If you want to point out some problems, you'd better have a better solution. **** or get off the pot.

Finally, regarding VA health and subluxations: just because it's law, doesn't mean it's scientifically sound. Edmund Crelin, a Yale anatomist, has done research on the effect of subluxations on nerve impingement. He found that for a nerve to be impinged by the spine, enough force must have been generated to fracture the spine. Hmmm.
 
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Look, as I hope some of you can now see, the real issue here is not one of science, rather one of health policy. Regardless of whether manipulation works (as peformed by a DO, MD, DC, or PT), the question is ultimately who should have the responsibility and liability of diagnosing and treating patients?

As a DO, I have a lot of experience and success with manipulation for a variety of musculoskeletal and even some nonmusculoskeletal disorders. I think that manipulation can be a useful ADJUNCT to a variety of other treatment modalities. I am uncomfortable with non-physicians diagnosing and treating potential MEDICAL problems.

If a DC wants to work with a group of spine surgeons, fine; power to him. I will bet you ANY amount of money that the DC does not get the "first crack" at working up patients. I've seen this practice model in action before: Patients present a multispecialty group are evaluated by a surgeon or physiatrist who determines what the underlying problem is any refers the patient within the group to the appropriate professional: PT, OT, physiatry, ortho or neurosurgery, or manual medicine. In these situations, the DC or other manual therapist is working under the supervision of a medically trained physician who has already "worked-up" the patient.

As for the VA bill, it was stalled by efforts of the AMA and AOA:

<a href="http://www.chirobase.org/08Legal/VA/aoa.html" target="_blank">http://www.chirobase.org/08Legal/VA/aoa.html</a>

<a href="http://www.chirobase.org/08Legal/VA/ama.html" target="_blank">http://www.chirobase.org/08Legal/VA/ama.html</a>

The real issue is how much scope of practice are medically-trained doctors going to let other groups co-opt? Think about it...The chiropractic profession is not interested in working "cooperatively" with organized medicine. Hell, no! They want to act in the best interest of their members by expanding chiropractic scope of practice and reimbursement. They would even like to restrict manipulation to DC's only when, in fact, DO's were the first group to professionalize the practice of manipulation in the United States, and not one study exists showing that DC's are intrinsically better trained to perform it! It's not about science people!!

<a href="http://www.aoa-net.org/Government/stateaffairs/spinalup200.htm" target="_blank">http://www.aoa-net.org/Government/stateaffairs/spinalup200.htm</a>

<a href="http://www.chiroweb.com/archives/17/17/20.html" target="_blank">http://www.chiroweb.com/archives/17/17/20.html</a>

<a href="http://www.va.gov/OCA/testimony/03oc00FM_USA.htm" target="_blank">http://www.va.gov/OCA/testimony/03oc00FM_USA.htm</a>

<a href="http://www.amerchiro.org/government/va/fringe_100900.shtml" target="_blank">http://www.amerchiro.org/government/va/fringe_100900.shtml</a>
 
Ponyboy (from the Outsiders, right??? how creative)

Finally, regarding VA health and subluxations: just because it's law, doesn't mean it's
scientifically sound. Edmund Crelin, a Yale anatomist, has done research on the effect
of subluxations on nerve impingement. He found that for a nerve to be impinged by
the spine, enough force must have been generated to fracture the spine. Hmmm.

So, are you saying that when the FDA okays a drug, or medical procedure, that doesn't necessarily mean it's scientifically sound?? So, just because you, as a physician, use some medical technique or drug, that doesn't mean it's physiologically, scientifically, rationally, or logically sound. Come on, you can't come up with something better than that?

Are you still trying to define Chiropractic by the foot-on-the-garden-hose theory??? Man, we abandoned that theory 50 years ago. Where ya been??? Try reading about the central integration theory instead. There's a little neurology involved so break out your little neuro textbook and if your going to slam Chiropractic, at least do it in this century!!

I think that it's a little ironic, that a DC (who claims to be a PCP) is jeering at the 4th year med student "playing doctor." Are you that hurting for irony in your life?? Eat some leafy green vegetables, esp. spinach, and you get all the irony you need.

I can not think of one time where I have seen a DC treat a common illness such as CHF,
OM, CAD, pneumonia, URTI, UTI, or DM. I have yet to see a DC directly refer a patient to a pulmonologist, a CV surgeon, or a hematologist-oncologist.

You never will see a Chiropractor treat those conditions. It's not within our scope of practice, but as far as the referring goes, when did you work for a Chiropractor before?? In all your experience with DC's, you worked with one on a daily absis when??? Maybe no Chiro has ever referrred to YOU. I've referred many, many times. Ok, short list of the conditions I've diagnosed (b/c I can in Indiana) and referred on for medical care (conditions the family docs MISSED, I might add): popliteal blood clot (saved her life), prostate cancer that had spread to the coxa, rib fracture missed by the company MD, gall stones (denied by the patients MD), need I go on Mr. I'm-the-expert-on-what-every-chiros-does-all-the-time-even-though-I've-never-worked-with-one? Now, before you go off on a snit, am I saying that Chiro's haven't made mistakes??? Absolutely not. But it definately goes both ways, and yes, for the 11 hundredth time, chiros can diagnose. Whether you rant and rave over we can or can't, in most states we can. Deal with it.
-------------------------------------------

Clown: What the above means is that a subluxation is a joint problem
It is a joint problem, with a neurological and muscular component. Again, go read up on the central integration theory and it will explain it all to you. If you are serious about some anatomical schooling, then send me an e-mail and we can discuss it off the record. For me, a subluxation is a philisophical concept. I use strictly motion palpation, ortho-/neuro analysis, subjective complaint, etc., to decide where I adjust the patient. The health of a joint is determined by how well it moves. I use x-rays to rule out pathology. Some of the Chiro organizations are rooted in philosophy. But obviously the Chiropractic profession is fractured in deciding who represents them, so the WCA does not represent everyone. It doesn't represent me. None of them do. There are many, many MD's that are not in the AMA and the AMA does not speak for every MD. If you want to talk about me and what I think and I how I treat patients (or refer as needed) then let's have it. I have an excellent working relationship with several MD's and DO's in Ft. Wayne. If Chiropractic was so dangerous and we are not to be trusted b/c of our incompetence, then why the referrals to me?? That's all I'm asking. Are Chiro's a threat to your self-esteem or professional identity? If not, then learn to coexist b/c we're not going away.

By the way, thank you for wishing me luck. My interview really rocked. The last two Chiros that went to IU were ranked 1 and 2 in their class. I interviewed late so I didn't expect to hear anything too quickly. I should know by June 1. We'll see.

TB
 
The chiropractic profession is not interested in working "cooperatively" with organized medicine.
If you mean become subservient to the medical profession, no we're not cooperative. When you're ready to treat us like peers, then yes, I'm all for it. But we're not "beneath" the god-like medical ego. We are a distinct profession. You're just PO'd that the DO profession sold out to the medical profession 100 years ago. We decided to stay and fight for autonomoy. Sounds like you're bitter about that. By the way, did you know that there are many MD's out there who think of you DO's as second-class citizens? So, I guess the law of survival states that you need to step on someone else to feel some sort of professional validation. Face it, you've met an MD or two who gave you little respect as a DO...fess up.

They would even like to restrict manipulation to DC's
Not true. I've never heard any DC organization call for the restriction of manipulation from DO's, just PT's. Are you paranoid?

not one study exists showing that DC's are intrinsically better trained to perform it! It's not about science people!!
That's right, it's common knowledge. No study needed. Kind of like, "did you know that the sky is blue?" "Oh, wait, better set up a study on that." Again, I refer to the fact that I receive referrals from DO's in my area. Why do you think that is? Could it be that I've adjusted more people than them? Practice makes perfect, and I'm getting close, bay-bee.

TB
 
Couldn't have said it better myself, Trey. Just one more note, there are chiro schools in the world beyond the US and Canada...In Austrailia, New Zealand, Europe.... Lady Di even had her own personal DC. More and more schools are becoming university based, as well. Yes, we have had an interesting and self destructive past (and we're still here..hmmm), I'm the first to admit it, but things are on the rise and getting better EVERYDAY. You're in danger of getting blindsided with that tunnel vision.
 
OH! and Mr. Happy, about that JMPT article, that is great. I think it's awesome that a DC is trying to draw some attention to the fact that we need more research. He's only trying to better our profession. And the profession, is only getting better. I just thinks it's odd you think JMPT is so hokey when DO's use, read, and sumbit to it too.
 
Well, it is nice to see you are actually addressing issues as apposed to avoiding them and saying absolutely ridiculous things about therapists and Physicians.

Unfortunately the educational aspect and other outrageous claims are still at the core of the chiropractic problem. The articles I listed were just an example of the problems of chiropractic science...a problem that they continue to compound.
Undoubtedly, the bogus claims, shoddy science, and poor admission standards have hurt the credibility of your profession.
And if there still remains overuse of x-rays, anti-immunization propaganda, vetrinary chiropractic, activator methods, pediatric manipulation to aid ADHD, homeopathic treatments, "nutrition therapies" and chelation therapies...chiropractic will NEVER be taken seriously.
By the way, while I am glad that you are performing physical exams on your patients and aiding in finding medical diagnoses...realize that is what ANY allied/nursing care professional is SUPPOSED TO DO! When I was a PT, I aided the surgeons in making the diagnosis,or in the discovery of infection etc. No big deal, that is what everyone does! As far as lifesaving...well, I really think you were being observant and helpful rather than heroic. It is our job.

And by the way, remember, you MAY BE A DO someday Trey, I wouldn't bash them too much...you haven't even passed your FIRST exam yet! You have a long way to go regardless of the DO or MD route...being humble will get you far...because WE ALL THOUGHT we would dominate medical school, and that is a bit harder than one may think.
 
•••quote:•••Originally posted by Treybird:
•
So, are you saying that when the FDA okays a drug, or medical procedure, that doesn't necessarily mean it's scientifically sound?? So, just because you, as a physician, use some medical technique or drug, that doesn't mean it's physiologically, scientifically, rationally, or logically sound. Come on, you can't come up with something better than that?

You never will see a Chiropractor treat those conditions. It's not within our scope of practice, but as far as the referring goes, when did you work for a Chiropractor before?? In all your experience with DC's, you worked with one on a daily absis when??? Maybe no Chiro has ever referrred to YOU. I've referred many, many times. Ok, short list of the conditions I've diagnosed (b/c I can in Indiana) and referred on for medical care (conditions the family docs MISSED, I might add): popliteal blood clot (saved her life), prostate cancer that had spread to the coxa, rib fracture missed by the company MD, gall stones (denied by the patients MD), need I go on Mr. I'm-the-expert-on-what-every-chiros-does-all-the-time-even-though-I've-never-worked-with-one? Now, before you go off on a snit, am I saying that Chiro's haven't made mistakes??? Absolutely not. But it definately goes both ways, and yes, for the 11 hundredth time, chiros can diagnose. Whether you rant and rave over we can or can't, in most states we can. Deal with it.
TB•••••There is a large difference between the FDA and the senate passing laws on billing rights. The FDA is responsible for consumer safety of patients and makes its approvals based on scientific evidence. The senate can pass whatever bill they want without scientific knowledge (and depending on who pays them the most money).

My knowledge from chiropractors comes from my girlfriend's father (a DC) who I used to work for. Also, when I speak of referrals, I mean bonafide, worked up referrals. Did you phone up the cancer institute and schedule an appointment with the oncologist, send him a letter describing the PSA, your findings on the rectal exam (did you do a rectal?), and chest x-ray? Did you order the liver panel, the Alk Phos, and interpret the abd U/S before you phoned the general surgeon? Anyone can put a label on something and call it a diagnosis. But what really matters is if the diagnosis and referral is correct and worked-up. I have yet to see one patient who has been sent to the hospital or the clinic with a good diagnosis and work-up from a DC and I have never seen my former boss send a patient directly to a specialist.

If DC's can honestly diagnose any medical condition and have it permanently on a patient's State Medical File (medicaire, medicaid, whatever), I think that it's a testament not to a DC's ability but to the laxity of regulatory affairs. A medical condition should only be diagnosed by someone who can definitively treat the disease. Just as a family doc cannot diagnose a perforated viscus unless he has performed the surgery, a DC should not be making any definitive diagnosis unless he can treat it.

Finally, if this nerve impingement stuff is so outdated, why do I find this on ChiroWeb?

"Accidents, falls, stress, tension, overexertion, and countless other factors can result in a displacements or derangements of the spinal column, causing irritation to spinal nerve roots. These irritations are often what cause malfunctions in the human body. Chiropractic teaches that reducing or eliminating this irritation to spinal nerves can cause your body to operate more efficiently and more comfortably."

Maybe I'm not the only one who needs to get into this century.
 
To everyone,

I think its unfortunate that this constant "play-the-other-down" attitude exists between our chosen professions. Just the other day I went to see a chiropractor about this dull ache I get in my neck after a long day of studying. He asked me what I was studying for and when he found out that I am to be starting medical school this fall, he immediately got defensive with me. Telling me about how medicine kills people and what not. In fact, he even questioned my motives about why I wanted to go into osteopathy. He claimed that osteopathy only re-adopted OMT within the last few years. If that was true, then why do all the DOs I know, both young and old, know how to do the art? He also went on to tell me that osteopaths sold out to medicine and what not. Excuse me, but A.T. Still was a doctor (MD)in the first place. And what the heck? I didn't go to this guy to talk about osteopathy versus chiropactics. I went to see him about my neck!

My point is, our professions need to work together in order to achieve what is best for our patients. MDs/DOs need to give credit to chiropractors for helping to relieve patients' headaches and back pains, where traditional medicine has failed. And chiroprators also need to realize the limits of their practice and be able to refer a patient to a specialist when it's necessary. It works both ways. Besides what do we get by defending ourselves to one another? . . . pride? Too much of it is destructful, trust me I know. There is nothing better than a little humility now and then to help us know that we are not gods, but rather, people doing our best to help our patients.

DFrancyk
 
JenMac, you go girl. Thanks for the support.

And by the way, remember, you MAY BE A DO someday Trey, I wouldn't bash them too much.
I will be a DO someday and I'm not bashing the profession, just some of the ignorance within the profession. Isn't that what you're doing? Chiropractic as a profession works, even though there is ignorance within the profession. Trust me when I say that I will take that opportunity with as much humility and reverence as I did going to Chiropractic school. And when the time arises to defend DO's, I will do it with as much zeal as I do the Chiro profession. I don't take being accepted into DO school lightly and I'm excited to have that opportunity, but I won't drop my Chiro paradigm either. I know there's a tough road ahead but I know that I can conquer it, as I'm sure you did. I had an excellent basic sciences education at Palmer and I know that will make DO school easier than had I not gone. When you've gone to Palmer then you can comment on the quality of it's education. Until then, you have no idea about our level of education. The two professions, at the heart, have the same philosophy from opp sides of the same coin.

I never said that the Chiropractic profession didn't have problems. All professions do. The problem I have is with people outside the profession telling us what our limitations are. As with anything else, changes have to be made from within, and they are. The profession itself has made great strides just in the last 20 years. Some of the issues you mentioned are not mainstream Chiropractic so I won't even address them. Activator is a viable and useful technique, and vet. Chiropractic is just as valid as human. If you, as a DO, feel that spinal misalignments affect the integrity of a human, then why not an animal? Again, it is not mainstream practice and should not be performed by someone who has not been trained adequately in the field. Pediatric adjustments should be made to correct vertebral misalignment and nerve interference, and that's it. Children should not be "trated" for ADHD with an adjustment, and most Chiros will tell you that. Again, we don't treat organic diseases, only spinal misalignments. I don't know how many times I have to repeat that before it sinks in.

As far as lifesaving...well, I really think you were being observant and helpful rather than heroic. It is our job.
I never said I was heroic, but of course you would take it that way. My point was that Chiro's have the training to make such obsevrations, thank you very much.

My point is, our professions need to work together in order to achieve what is best for our
patients. MDs/DOs need to give credit to chiropractors for helping to relieve patients' headaches and back pains, where traditional medicine has failed. And chiroprators also need to realize the limits of their practice and be able to refer a patient to a specialist when it's necessary.

DFrancyk: I agree with you 100%. This has turned into a pissing contest. My point has always been it's about what's best for the patient and I agree that my profession has limitations. I am the first one to admit that if treating something is outside the scope of our practice, then refer them out ASAP. I don't believe that adjusting a patient will cure cancer, cellulitis, liver disease, etc. But most DO's/MD's have no idea what Chiropractors can do or can't do b/c you don't know what our training is. Only the Chiro profession and legal system can place those restrictions. Once you start telling us how to practice then it sounds like you're getting defensive that we're stepping onto your territory. Relax, we're not looking to steal your organic disease patients, but you can bet that 99% of the population are walking around with spinal misalignements that, if left uncorrected, will cause problems down the road.

Just like a cavity that goes undetected until it hits critical mass and causes pain, pain is a poor indicator as to whether there are spinal misalignments or not. And do you NOT think that a spinal misalignement won't affect the nervous system at that level?? Honestly?? If not, where were you in A & P? Stretching of the joint capsules and distortion of the outer 1/3 of the annulous fibrosis causes an influx of sensory info at that segemental level causing interference with the other nerves at that level, like the static you get on your cell phone going under a power line. As those nerves carry motor info to the organs and muscles innervated by that segmental level, those organs and muscles will be affected. This is an oversimplification, but it's just meant to illustrate how spinal misalignments do affect the nervous system, not just the muscles (which, by the way, are controlled colely by the nervous system. If it can affect muscles, it can affect other systems as well. Chiropractor shave traditionally vied the human body differently than medicine. I don't know why, other than differences in paradigm. BUT, I think that ultimately we compliment each other. I think that we all have a place in healthcare.

I've not heard ANY of you DO's out there point out one shortcomming of your profession. All I've heard is how bad Chiropractic is, what our limitations should be, and what changes we need to make. You admit your problems as a profession and I'll admit ours. But all you've done is attack and criticize. Of course I'm not going to bow down to that kind of attack. Give us respect and I'll give you respect. That's where it all begins. So, if any DO's or MD's would like to have a constructive dialogue, then let's do it. But don't start out attacking or we'll just end up in another pissing contest.

TB
 
•••quote:•••Originally posted by Treybird:
•Ponyboy (from the Outsiders, right??? how creative)

Finally, regarding VA health and subluxations: just because it's law, doesn't mean it's
scientifically sound. Edmund Crelin, a Yale anatomist, has done research on the effect
of subluxations on nerve impingement. He found that for a nerve to be impinged by
the spine, enough force must have been generated to fracture the spine. Hmmm.

So, are you saying that when the FDA okays a drug, or medical procedure, that doesn't necessarily mean it's scientifically sound?? So, just because you, as a physician, use some medical technique or drug, that doesn't mean it's physiologically, scientifically, rationally, or logically sound. Come on, you can't come up with something better than that?

TB•••••Ponyboy was saying that gov't approval isn't NECESSARY) Necessity and sufficiency are two different things. Sufficient conditions such as scientific testing, etc. make FDA approved drugs SOUND. Learn some logic before you apply these arguments.
 
It's pretty easy to sit on the sideline and throw out a comment once in awhile, isn't it? How's that for logic? I guess you didn't read what I last wrote before your illuminating comments, eh? You feel the need to go back and start with the pissing contest again? Do you feel better now that you've gotten that off your chest? Try something constructive. :p

moooooooooooo
 
Oh hell, I can point out many faults with OMT education in particular...these are often shared with chiropractic, but not to the same extent.
Cranio-sacral techniques are absolute fringe techniques that have ZERO experimental proof and are shaky theoretical grounds. The continued support for this technique CONTINUES to bite DO's in the ass! The same can be said for Chapman's Points and the continued use of NON-objective measurements of spinal mobility and the absolute LACK of outcome data regarding manipulation. Other than patient satisfaction, true outcome data is lacking.
I was the FIRST to criticize these things in school...as a PT you have research out the WAZOO...you had better be able to document objective data or you simply will not get reimbursed. I did a fair share of research as a student, but OMT research has a tendency to be "soft", as with chiropractic. That simply will not do.

Come on dude...the Activator Method?! THat is right up there with magnets and copper wrist bands. As far as pediatric manipulation, well, I can tell you haven't done much true academic research. Interrater reliability for palpatory diagnosis is absolutely terrible...terrible. Pediatric manipulation has NO PLACE in medicine of any sort.
 
•••quote:•••Originally posted by Treybird:
•It's pretty easy to sit on the sideline and throw out a comment once in awhile, isn't it? How's that for logic? I guess you didn't read what I last wrote before your illuminating comments, eh? You feel the need to go back and start with the pissing contest again? Do you feel better now that you've gotten that off your chest? Try something constructive. :p

moooooooooooo•••••Maybe cuz I don't sit here and check this thread every five seconds.
 
Happy Clown:

I agree that there still needs to be more specific research, and it's nice to see that Palmer is finally starting to get that done, along with National College near Chicago. The problem to date, and you have to agree with me here, is that we don't have the high dollars supplied by drug companies for research. We're only now starting to get NIH funding. It's not for a lack of interest in research b/c most big schools, like Palmer, have dedicated some serious space towards research, it's a lack of funding.

I know manipulation works because I've seen it work. And I'm talking about the mainstream techniques that are taught as standard in most schools, not the fringe techniques. I will be the first to admit that there are some serious nut job techniques out there, like neuro-emotional technique (i.e. channeling energy from God or some such etheral electricity source). I guess , like anything else, there are fringe elements, but they are not representative of the mainstream. I have a very big problem with Chiros who claim they can cure things. Most will tell you they can't and most have very good relationships with local docs in case they run into something they need to refer out. My only goal is to get patients out of pain and back to feeling better. Chiropractics biggest problem is unification. It's our downfall and one of the reasons we can't always get things done. There was a split early on in the profession and we've never recovered. It's one of the things I truly hate about my profession. Activator is good for children and old people b/c it's very specific and can be less invasive. Just for the record, I don't use it. I hate having it done to me b/c it hurts and it's annoying, but some people have walked in and out my door b/c I didn't do activator. I really don't know enough about it to comment beyond that. I was never interested in it b/c I like to use my hands, not a little spring-like door stopper.

I agree that interdoctor palpation reliability does suck. 100 different DO's/DC's could potentially find 100 different things but hopefully the doc uses all resources necessary to find where the problems are, including checking reflexes, ROM, EMG studies, postural analysis, ortho/neuro tests, etc. I referred a patient to a neurologist for a second opinion and the patient told me that this doc did the same exact ortho-neuro tests and told her the same exact thing I did, only he charged her about $400 more. The point is that hopefully most DO's and DC's are truly workinig the patient up to find out where the problems are.

So, they must have loved you in DO school. Why don't you get into research since it sounds like you're very oriented in that direction. I hate doing research. It bores the hell out of me. But, I like to read up on studies to see what's going on. Have you ever checked out the JMPT or Spine? Good mags. So, are you in practice now or residency?

TB

moooooo, let it go guy....it's over...the dialogue has begun....try being constructive.
 
Oh, I have been interested in research, except mine apparently was a bit too much for the hard core osteopaths...it included "Q-angle measurements in male and females and correlation with patello-femoral disorders?"...called "too reductionistic and not osteopathic enough" "3 techniques for measuring forward flexion and the reliability of each to determine pathology"...called "not osteopathic enough". also indwelling elctrode determination of muscle activation during select "muscle energy techniques". Also, a study determining if "touch alone creates a considerable plecebo affect", this would occur if a defined medical diagnosis was given, medical treatment of NSAIDS and mild narcotics was kept constant between the 2 groups, except the control group would have NO HUMAN TOUCH during evaluation and treatment, while the experimental group would have "sham treatment".

The only way to PROVE manipulation really works, is to create objective data for it...AND TO TRY TO DISPROVE IT.
These were some of my projects, and proved a bit too scary for funding. But otherwise, you are left with soft data and testimonials. Not good. Oh, I believe manipulation works to a degree...but as a PT (when I did not manipulate; but did perform PNF {muscle energy} and intense soft tissue and myofascial techniques), I was able to get 80-90% of my low back pain and cervical pain patients 75% better (subjectively measured with return to ADL'S with less pain) in roughly 3-5 visits...2 weeks. That simply begged the question regarding outcome data for LBP patients and technique specific data. My patients got better VERY quickly with virtual NO return to therapy other than the 5 visits. (except for fibromyalgia/chronic pain patients which have a CONSIDERABLE psychiatric component and overall low aerobic/anaerobic tolerance)

I am an Emergency Medicine resident (start in june) with intention of doing a fellowship in Sports Med.
 
I think your research ideas sound great. Are you sure you don't want to do research at Palmer. We'd love to have you. There is definately a placebo affect by putting your hands on someone. No doubt about it. But you can't do reasearch in a vacuum b/c life is not in a vacuum. Our minds have a lot of control over the body, pain, healing, etc. and touch. Even though it may only be a placebo effect, and unknown variable, it is an important component in treatment. Think how more relaxed your patients are when you come over, talk to them and reassure them that they'll be alright. They can relax a little, if they're not uncouncsious or in shock, and decrease some of the stress hormones that are making things worse. Know what I mean? I understand that you want to isolate and get the direct skinny on whether manipulation works, but can you really rule out the human element of it all? I think research should be done in a way that mimics the real life situation. Maybe that's what case studies are for. My naivete coming through. That's why I don't do reasearch.

My undergrad degree is in exercise physiology (from Rutgers) and I've been thinking about Sports Medicine via Family Practice. It all depends on what the Air Force allows me to do. Where did you go to school and where are you doing your residency?

TB
 
Treybird - I had a quick question for you. You stated previously that as a DC you read your own Xrays. On my clinical rotations, the MD/DO's will make their own interpretations, and then wait for comfirmation from the radiologist. Do you still need a radiologist peform an "official" read, or is your interpretation the final word? If so, does this affect your malpractice premiums?
 
As a DC we are fully qualified to take and read x-rays, which, I assume is part of our malpractice insurance. They've never asked my whether I read my own X-rays or not and I get charged just the same. We had a year and a half of X-ray analysis in school and we are tested on radiology both nationally and on state license exams. I, however, chose not to take my own X-rays, because I can't afford a unit, so all X-rays I require are automatically referred out and read by a radiologist. I am confident in my Chiropractic analysis of X-ray and know enough pathology to know when to refer something out for a second opinion. I won't diagnose pathology. I will review any X-rays I order for my own knowledge and will call and ask the radiologist any questions I have. One of the biggest things that Chiros get sued for is missing a diagnosis. Chiros can go on in their post-grad education and specialize in radiology. It is a 3 year residency and they are just as qualified as any medical radiologist.

TB
 
Come on dude, you were doing really well there until the "just as qualified as a medical radiologist" stuff came about. But that is ok.
As a chiropractor, one deals with selected pathology...typically that of the spine. And in a court of law, even IF you missed a bone carcinoma, you would NOT be held to the same standards as a Radiologist. A "chiropractic radiologist" WOULD NEVER be considered an expert witness...nor would their diagnosis hold up in a hospital.

To answer the question simply, a radiologist or orthopedist ALWAYS will re-order and re-interpret chiropracic radiographs...always. A chiropractic x-ray or interpretation does NOT HOLD UP medically.
I have seen it time and time again in FP, orthopedics, and in Radiology. That is just the way it is in real life.
Radiology is one of the top 5 most difficult residencies to achieve in post graduate medical training...primarily because of their extensive knowledge of anatomy and in particular PATHOLOGY of every sort.

I went to Indiana University for undergrad, went to U. of St. Augustine for graduate work, went to UHS for medical school and to Wright State for Residency. Sorry if the above sounds harsh, it is not intended to incite.
 
Well, all I can tell you is what I've been told. I have no practical experience as a chiro radiologist so I'd have to defer you to one b/c they could tell you more about what they do, their level of education, standards of practice and legality. As I said, I don't take my own X-rays so for me it's a non-issue.

Trust me, if we missed a carcinoma on an x-ray that we took, you'd better believe that we'd be held accountable. With our level of education in X-ray, granted not nearly like a radiologist, but more than the average MD or DO, we would legally be held accountable. I've heard about docs getting sued b/c they missed a pathology on an X-ray. Now, some states limit where you can X-ray (like Michigan - only the spine), but in Indiana I can X-ray anything and whatever I X-ray I'm responsible for. It's part of the license. Believe it or not we do have a lot of responsibilties in our practice, even if we're second guessed by the medical profession.

Radiology is one of the residencies I'm currently considering. What do you know about interventional neurovascular radiology? I've heard it's pretty cool. I really do like radiology but would probably miss the direct patient contect.

TB
 
Ok I will address 2 things.

First, as a medical student (especially years 3 and 4) then as a physician, you will be bombarded with radiographs daily. From the most mundane chest film, to CT's of the head or MRI's of the shoulder. Every physician and every student will see his/her share of fractures and lucunar infarcts. It is even on step 2 of the USMLE and COMLEX for medical students...regardless if you took a radiology rotation or not. Because of the way medicine is percieved if a DC misses a carcinoma...sure, he can be sued but not for NEARLY as much as if he was MD/DO...the expectations are FAR FAR MORE. No one EXPECTS the DC to know the beginning osteolytic changes of metastatic carcinoma. Medico-legal expectations and standards are far different. You can sue anyone, but if the standards are higher for one profession...so are the expectations.

Second, radiology is a great field. Residencies are VERY difficult to get into these days...and invasive fellowships are competative. A radiology residency I believe is 3-4 years after the internship year. <a href="http://www.scutwork.com" target="_blank">www.scutwork.com</a> has a link for radiology residencies if you are interested.
 
In Indiana there's a cap on what a person can sue for, MD or DC, but any lawyer, regardles of what they EXPECT, will sue for the max amount and yes, a Chiro is trained to spot the beginnings of osteolytic or osteoblastic carcinoma, as well as most other bone pathologies. A Chiro will get sued for as much as any doctor, we just don't get sued as often. Not because we're better, but b/c people are on the prowl when it comes to suing MD's. They almost expect to sue if some little thing goes wrong, hence the cap.

Anybody who is licensed to take and read X-rays is held to the same standard regardless of whether you're an MD or DC. If you don't agree with this then I can put you in touch with the lawyers who serve the ACA. We are told this every year when we have our risk management updates. I doubt they're just telling us this to boost our egos. I get the feeling that you think we have less standards or that there are less expectations placed on Chiros. I can tell you that this is not true as I live it every day. I know what the expectations are and I know what the legalities are. And I know that if I screw up, I'm just as liable for that screw up as you, albeit mine are not life-threatening. Research aside, why do you have such a negative attitude towards Chiropractic? I mean it just sounds very condescending. Have you been to one? Did you have a bad experience with one? If you're not happy with the DO research then why did you become a DO and not an MD?

Ok, tell me you're NOT a Bobby Knight fan. I actually rooted for IU in the Final Four. Well, Mike Davis actually. Are you from Indiana? Why did you choose ER medicine?
 
Taken from the Chiropractic Act of Indiana:
"However, chiropractic does not include any of the following:
(A) prescription or administration of legend drugs or other controlled substances;
(B) performing of incisive surgery or internal or external cauterization;
(C) penetration of the skin with a needle or other instrument for any purpose except for the purpose of blood analysis;
(D) use of colonic irrigations, plasmatics, ionizing radiation therapy, or radionics;
(E) conducting invasive diagnostic tests or analysis of body fluids except for urinalysis;
(F) the taking of x-rays of any organ other than the vertebral column and extremities ; and
(G) the treatment or attempt to treat infectious diseases, endocrine disorders, or atypical or abnormal histology."

The law itself does not allow DC's to interpret anything but skeletal radiography. How can DC radiologists be anywhere near the same level as medical radiologists? How can DC's have anywhere near the same exposure to radiologic pathology as MD/DO's?

Secondly, in regards to level of training:
EXPERT WITNESS CASELAW: STATE CASE - INDIANA
Chiropractor on Medical Reports of Physicians
Faulkner v. Markkay of Indiana, Inc.
663 N.E.2d 798 (Ind.App. 1996)

EXPERT: Chiropractor: Phillip Sprinkle
ISSUE: Admissibility

The Indiana Court dealt with a customer who slipped and fell in a grocery store.
The issue for expert testimony was whether a chiropractor, Sprinkle, would be permitted to restate the opinions of orthopedic surgeons and a neurosurgeon upon who he relied.
The court found as the chiropractor lacked similar training and could not be cross examined on this issue, he would not be permitted to restate the opinions of the doctors.
The court stated:
The evidence rules do not permit the admission of materials, relied upon by an expert witness, for the truth of the matters they contain if the materials are otherwise inadmissible. Here, the materials were inadmissible because Dr. Sprinkle, a doctor of chiropractic, does not have the same education, training or expertise as the physicians who prepared the reports. We cannot allow an expert's reliance on hearsay to be employed as a conduit for placing the physician's statements before the jury. The expert witness must rely on his own expertise in reaching his opinion and may not simply repeat opinions of others.
 
Who said anything about X-raying organs? Didn't I say the laws varied from state to state?? Did I ever say that a Chiropractor was considered an expert witness over a neurologist or orthopedist?? Hmmm, maybe what I said was that I referred patients to an orthopedist or neurologist for further study. Wouldn't that indicate that they were the specialist? Did the voices in your head indicate that I said something different?

PonyBOY get a life. You're like my little dog who gets excitied and tinkles on strangers. Can you do anything constructive? Try putting that much studying and research into your work in medicine b/c your opinion means absolutely nothing to me, or my professional peers, for what I do. Glad it irked you enough to do some research though. Thanks for that update on Indiana law. Can you tell me the laws on Illinois since I may be going to school there and I need to know what to do to transfer my license. Oh, check out NJ too while your at it. Thanks. Keep up the good work. What would the medical profession do without your watchdog diligence?

TB
 
Can anybody move beyond the "my johnson is bigger than your johnson" stage and have an open, non-attacking, mutually respectful conversation?? Is that too hard, cause this is really getting old. You must feel all mighty against one Chiropractor.
 
Hi Treybird,

I am about to graduate from TUCOM in a few weeks, and I start internal medicine at UC Irvine in southern cal in June.

Sorry it took me a while to get back to you. I am enjoying this thread though.
 
•••quote:•••Originally posted by Treybird:
•Who said anything about X-raying organs? Didn't I say the laws varied from state to state?? Did I ever say that a Chiropractor was considered an expert witness over a neurologist or orthopedist?? Hmmm, maybe what I said was that I referred patients to an orthopedist or neurologist for further study. Wouldn't that indicate that they were the specialist? Did the voices in your head indicate that I said something different?

PonyBOY get a life. You're like my little dog who gets excitied and tinkles on strangers. Can you do anything constructive? Try putting that much studying and research into your work in medicine b/c your opinion means absolutely nothing to me, or my professional peers, for what I do. Glad it irked you enough to do some research though. Thanks for that update on Indiana law. Can you tell me the laws on Illinois since I may be going to school there and I need to know what to do to transfer my license. Oh, check out NJ too while your at it. Thanks. Keep up the good work. What would the medical profession do without your watchdog diligence?

TB•••••Look buddy, you're the one going on about how DC's get MORE training in radiology than the average MD/DO. ("With our level of education in X-ray, granted not nearly like a radiologist, but more than the average MD or DO, we would legally be held accountable.") I'm simply asking a question. How can you say that DC's have more radiology training if you don't look at anything but the bones?

You're the one who said, "I get the feeling that you think we have less standards or that there are less expectations placed on Chiros. I can tell you that this is not true as I live it every day." I simply provided information that said otherwise.

I have only presented arguements that have been backed by legal and scientific fact. But yet, you try to insult me personally? And now, you ask for an "open, non-attacking, mutually respectful conversation"? If you don't want this discussion to be a pissing contest, don't go around saying that DC's are better or as good as MD/DO's (regardless of it's veracity). Somebody will call you on it.

Look, you're always crying out for evidence-based discussion. And yet, as soon as I post evidence-based material that is contrary to some of your statements, you hurl insults and sarcasm at me. You made your statements regarding the education of DC's, I disagreed. I posted support for my disagreement, you returned with a very unprofessional reply. I have made my professional reply. Make yours.
 
I'm sorry but is the above post from the same person who asked for this discussion to turn into a "non-attacking, mutually respectful conversation"?
 
When I get respect, you'll get respect.

Do you feel that the above comments before mine were respectful? You don't feel the need to comment on anyone else's comments but mine? Whatever, dude. Must be tough all ganging up on the one Chiro. Hmmmm...how brave.
 
I don't agree with the post before you at all. That was uncalled for but your comments were as well. Let's try to remember the golden rule, treat others as you would like to be treated, not how others treat you.
 
Ouch! that was a shot below the belt. I know! Your mama so ugly.... no. How about your mama so fat..... no, nevermind.
 
Holy war-of-words Batman!

Back to the radiology issue. The issue being, about 2/3's of all radiographs in the hospital are of internal organs or neurological structures and 1/2 of all structures radiographs in the ED are internal organs etc...That is why Ponyboy made a case against your previous statement about "better than the average MD/DO" while reading films. We READ ALOT...and they are anything from chest xray(lungs/heart) to obstructive series (2-3 views of the abdomen) to CT of the head or pelvis. When Xrays are taken, the general concensus is that there had better be an acute problem for a patient to exposed to radiation!

I don't think we are gonna agree regarding the legal issue. I can guarantee that because the general public and professional world see the MD/DO degree more difficult to obtain and with more difficult training and standards...people expect more from them. Example...if you order a thoracic film of the spine (due to thoracic pain and a true somatic dysfunction of the spine) and you miss a dime size lesion in the right upper lobe...people WILL NOT hold you to the same standards as they would a physician! You simply do not see that type of pathology, and you certainly are not looking for it. Sure, if it was me I would try to sue you...but the amount would be alot more if it was a MD/DO missing that call.

I have never had a bad one on one experience with a chiropractor...only the legal and professional issues when I was a practicing PT. As a PT, my exroommate's brother was a DC and he told me openly about how he charged for physical therapy in his office. It was insulting because there was no therapist present...regardless of what the law allowed, I found it terribly unethical. There have been alot of other psuedoscience issues etc. Hell, I have had my fair share of debates with hard-core DO students!

Why did I ONLY apply to DO programs, well, I really did want to do research while in school. And I wanted to do Physiatry or Orthopedic Surgery (initially) and I thought I would be the REHAB KING (considering I am a PT and DO).
Then I saw the light of Emergency Medicine (ha!), it is perhaps the most challenging and fun field of medicine I have worked in. You have to know everything. Other choices would be radiology or cardiology if I had to choose.
 
Treybird,

I apologize for that remark being directed at you under my screen name. I assure it was not written by me...apparently i was not logged out of SDN when i left my computer and the message was posted by someone else. Again, i apologize. If you notice, i've deleted the post as well.

Scott
 
slindsay198, thank you and apology accepted. Good luck at PCOM. I was granted an interview there but decided to stay in the Midwest. I hear it's a great school.

happy clown, we'll just have to agree to disagree and leave it at that.
When I was going through undergrad, I did my exercise physiology internship at the Robert Wood Johnson Hospital Cardiac Rehab and was convinced that if I ever went into medicine that I would go into cardiology. Now I'm not sure. I was reading the book How To Choose A Medical Specialty and you're supposed to rank all the things your looking for in a specialty (i.e. decent time off, good money, patient contact, variety, regular hours, etc.) and I came out with emergency medicine. We'll just have to see what happens when I go through rotations. I'm still leaning heavily towards radiology and family practice. At least with FP I can still adjust my patients. What do you know about forensic psych? Did you do a psych rotation? If so, what did you think?

Have you found there to be any bias in your residency against you for being a DO? I've heard stories of that happening.

TB
 
dcdo, are you looking forward to IM? Where would you like to go afterwards? Did you like TUCOM? Where did you go to Chiropractic school?

TB
 
Treybird,

I'm pretty excited to get started, and I've wanted to do IM since the beginning of med school. Afterwards, not too sure, doubt I will subspecialize but you never know. I do like cardiology. If I stay in IM I should be able to do manipulation in the outpatient clinic. I went to LACC, graduated in 1994.
 
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