Preventing non-physician providers from misrepresenting their qualifications

toughlife

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“Health Care Truth and Transparency Act of 2006”

Rep. John Sullivan (R-OK) has introduced H.R. 5688, the “Health Care Truth and Transparency Act of 2006.” This legislation would strengthen FTC enforcement against limited-licensed health care providers and keep them from making deceptive misrepresentations as to their education, skills and training. It would also keep non-physicians from holding themselves out as medical doctors (MD), doctors of osteopathic medicine (DO), doctors of dental surgery (DDS) or doctors of dental medicine (DMD).

In furtherance of this new legislation, ASA was invited to join the Coalition for Healthcare Accountability, Responsibility and Transparency (CHART), a group of large national medical specialty and dental organizations dedicated to pursuing appropriate Federal legislative, regulatory and legal actions, such as support for H.R. 5688.

According to a recent survey, the vast majority of Americans—90 percent—want to know in advance of treatment if their provider is not a physician. Because of misleading statements and advertisements by some allied health professionals, however, patients are often confused about their providers’ qualifications.

CHART has documented numerous instances of non-physician healthcare providers holding themselves out to be medical doctors or doctors of osteopathy, or as having their medical qualifications, leading patients to believe they are seeing a medical doctor when they are not. Further, some allied health professional educational programs claim to offer the same training as four-year medical degree programs and subsequent medical specialty training. These false claims could mislead the public and endanger public safety.

ASA believes that H.R. 5688 would significantly reduce patient confusion and safeguard the public by prohibiting the dangerous practice of some health care providers who are not medical doctors using misleading terminology to misrepresent themselves or their qualifications. Patients should be confident in their healthcare decisions without having to second-guess their providers’ credentials.

http://www.asahq.org/Washington/HR5688.pdf
 

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Hi there,
Moving to Topics in Healthcare for more discussion value.
njbmd :)
 

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toughlife said:
June 29, 2006



According to a recent survey, the vast majority of Americans—90 percent—want to know in advance of treatment if their provider is not a physician. Because of misleading statements and advertisements by some allied health professionals, however, patients are often confused about their providers’ qualifications.


http://www.asahq.org/Washington/HR5688.pdf
I find it hard to believe that 10 percent would indicate that they did NOT want to know the credentials of a provider giving treatment. 90 percent seems kind of low.

I'm not sure what this bill is supposed to remedy. I assume it is already illegal in most or all states to practice medicine without a license and misrepresent your credentials. People who do this will continue to do so in spite of all the laws you pass to the contrary. If the bill is specifically targeted at PA's and CRNP's, then I don't know how many physicians will get behind it. Most practices rely on mid-levels and probably won't welcome the inevitable paperwork that comes with additional legislation.
 
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McDoctor said:
I'm not sure what this bill is supposed to remedy. I assume it is already illegal in most or all states to practice medicine without a license and misrepresent your credentials. People who do this will continue to do so in spite of all the laws you pass to the contrary. If the bill is specifically targeted at PA's and CRNP's, then I don't know how many physicians will get behind it. Most practices rely on mid-levels and probably won't welcome the inevitable paperwork that comes with additional legislation.
Reading the act:
"(a) CONDUCT PROHIBITED.—It shall be unlawful for 20
any person who is a licensed health care service provider 21
but who is not a medical doctor, doctor of osteopathic 22
medicine, doctor of dental surgery, or doctor of dental 23
medicine to make any deceptive or misleading statement, 24
or engage in any deceptive or misleading act, that deceives 25
or misleads the public or a prospective or current patient 1
that such person is a medical doctor, doctor of osteopathic 2
medicine, doctor of dental surgery, or doctor of dental 3
medicine or has the same or equivalent education, skills,4
or training. Such deceptive or misleading statements or 5
acts shall include advertising in any medium, making false 6
statements regarding the education, skills, training, or li- 7
censure of such person, or in any other way describing 8
such person’s profession, skills, training, experience, edu- 9
cation, or licensure in a fashion that causes the public, 10
a potential patient, or current patient to believe that such 11
person is a medical doctor, doctor of osteopathic medicine, 12
doctor of dental surgery, or doctor of dental medicine.
13​

I can see how this would prevent the current advertising of many DCs, NDs, and NPs. It would be a good thing.

- H
 

emedpa

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I don't know of any pa's who would have problems with this. we all take great pains to let folks know we are not docs. every state in fact requires us to wear name tags that spell out "physician assistant" prominently.
I'm guessing all the opposition to this bill will come from the DNP crowd.
 

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FoughtFyr said:
Reading the act:
"(a) CONDUCT PROHIBITED.—It shall be unlawful for 20
any person who is a licensed health care service provider 21
but who is not a medical doctor, doctor of osteopathic 22
medicine, doctor of dental surgery, or doctor of dental 23
medicine to make any deceptive or misleading statement, 24
or engage in any deceptive or misleading act, that deceives 25
or misleads the public or a prospective or current patient 1
that such person is a medical doctor, doctor of osteopathic 2
medicine, doctor of dental surgery, or doctor of dental 3
medicine or has the same or equivalent education, skills,4
or training. Such deceptive or misleading statements or 5
acts shall include advertising in any medium, making false 6
statements regarding the education, skills, training, or li- 7
censure of such person, or in any other way describing 8
such person’s profession, skills, training, experience, edu- 9
cation, or licensure in a fashion that causes the public, 10
a potential patient, or current patient to believe that such 11
person is a medical doctor, doctor of osteopathic medicine, 12
doctor of dental surgery, or doctor of dental medicine.
13​

I can see how this would prevent the current advertising of many DCs, NDs, and NPs. It would be a good thing.

- H
podiatry too.. for all those podiatrists who claim to have went to medical school
 

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emedpa said:
I don't know of any pa's who would have problems with this. we all take great pains to let folks know we are not docs. every state in fact requires us to wear name tags that spell out "physician assistant" prominently.
I'm guessing all the opposition to this bill will come from the DNP crowd.
Most patients understand the role of physician assistant, but a nurse practitioner hasn't been clearly defined to the public.

What happens if someone has a PhD or a doctorate in nursing? Can he or she introduce him or herself as Dr. so and so? Or must he/she add the clause that they are a PA or nurse practitioner after introducing themselves as Dr.?

(Granted the vast, vast majority of PA's and NP's do not hold doctorates, so this only applies to a few.)
 

emedpa

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southerndoc said:
Most patients understand the role of physician assistant, but a nurse practitioner hasn't been clearly defined to the public.

What happens if someone has a PhD or a doctorate in nursing? Can he or she introduce him or herself as Dr. so and so? Or must he/she add the clause that they are a PA or nurse practitioner after introducing themselves as Dr.?

(Granted the vast, vast majority of PA's and NP's do not hold doctorates, so this only applies to a few.)
pa's with doctorates are specifically prohibited from calling themselves doctor in a clinical setting. I know several pa, phd folks and they all introduce themselves like this;" hi, my name is john, I'm one of the pa's here in the emergency dept"
 

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How about this Physical therapy site?

http://www.resultsrehab.net/index.html

All of our therapists are Doctoral Candidates and practice clinically utilizing the most current evidence-based research.

He is currently working on his Clinical Doctoral Degree from Temple University to be conferred during the Summer of 2006.

Currently, Jennifer is working on her Clinical Doctoral Degree from Boston College.

Britta is working towards her Clinical Doctoral Degree
 

I Surgeon

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Many people from optometrists to CNRPs are trying to reject this bill. Here is a site to send an email directly to your representative with a push of a button. You will need to edit the prewritten letter as it is written for optometrists rejecting the bill. Here you go just add your specialty...

http://capwiz.com/theaoa/issues/alert/?alertid=8881916


Its time for all specialties in medicine to unite and end this propaganda.
 

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I Surgeon said:
Its time for all specialties in medicine to unite and end this propaganda.
Really?!? I'm for it! I have no problem with optometrists, nor with PAs, nor with most NPs, and I go to a podiatrist...

But, as things stand right now, DCs and NDs can (and do) legally state that they "went to medical school". The public does not comprend the difference between their schooling and that of an MD/DO. (e.g., http://answers.yahoo.com/question/;_ylt=AiBU.Sos4qsTeLklBxUzEEYjzKIX?qid=1006052221652) Legislation like this is important, especially given the "graying of america" and the impending shortage of providers, to help an unwitting public understand their options. There are many times where a provider other than an MD/DO is appropriate, and that is supported both in practice and in position statements by MD/DO groups. B ut unethical providers, especially those in sCAM fields, really oversell their "education" to their patients!

- H
 

ForbiddenComma

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There are some "bad egg" NP's who want to have all the privileges of being a physician, without having to work for it. Fortunately, they are in the minority.

imo, an accelerated NP/PA-to-MD program may help relieve some of the problem. It doesn't make much sense to me for a NP or PA to have to go through the usual 4-year ordeal when they already have so much clinical experience.
 

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ForbiddenComma said:
It doesn't make much sense to me for a NP or PA to have to go through the usual 4-year ordeal when they already have so much clinical experience.
Sure, it does. It's called "consistency." The biggest reason that there's so much inconsistency in knowledge bases from one midlevel to another is the fact that these fields rely so much on prior clinical experience, which is not uniform. The reason it works is because of oversight...by physicians.
 
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FoughtFyr said:
Really?!? I'm for it! I have no problem with optometrists, nor with PAs, nor with most NPs, and I go to a podiatrist...

But, as things stand right now, DCs and NDs can (and do) legally state that they "went to medical school". The public does not comprend the difference between their schooling and that of an MD/DO. (e.g., http://answers.yahoo.com/question/;_ylt=AiBU.Sos4qsTeLklBxUzEEYjzKIX?qid=1006052221652) Legislation like this is important, especially given the "graying of america" and the impending shortage of providers, to help an unwitting public understand their options. There are many times where a provider other than an MD/DO is appropriate, and that is supported both in practice and in position statements by MD/DO groups. B ut unethical providers, especially those in sCAM fields, really oversell their "education" to their patients!

- H
Are you saying it is legal for a DC ( or any non-MD for that matter) to say that he went to medical school when he did not? Is there a difference between "went to" and "graduated from". How about DO's who say they went to medical school? Technically, isn't it osteopathic medicine? Many DO's omit the DO after their name and just call themselves Dr. Many patients do not even know they are going to a DO.
 

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611 said:
Are you saying it is legal for a DC ( or any non-MD for that matter) to say that he went to medical school when he did not? Is there a difference between "went to" and "graduated from". How about DO's who say they went to medical school? Technically, isn't it osteopathic medicine? Many DO's omit the DO after their name and just call themselves Dr. Many patients do not even know they are going to a DO.
Actually, yes, I am saying that it is currently legal for a DC to outright state that their education is equal to (or greater than) that of an MD or DO. And in my experience, many do. If you go to sites, such as Yahoo questions, where the general public asks and answers questions, you will find that many people not only believe that chiropractors went to medical school, but that the DC is some sort of "additional training" after the MD and residency. There are several chiropractors' websites that attempt to demonstrate that chiropractors have "more education" than MD/DOs. (see: http://www.drlowe.com/jcl/comentry/mddceduc.htm and http://www.drgrisanti.com/mddc.htm) This sort of deceptive marketing should be illegal. This bill would make it so.

As for the DO - their education (at accrediated schools) is absolutely and 100% equal. If they wish to market themselves as MDs - so be it. In every state, they enjoy the same unrestricted licenses as MDs.

- H
 

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Interesting that the DC v. MD page doesn't include hours for medicine, pediatrics, emergency medicine, critical care, general surgery, etc. "Some" medical schools require a bachelors? "Some" medical schools require the MCAT? HA!

That was a funny laugh.

Alas, in my state, DC's and ND's are licensed by the state.
 

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southerndoc said:
Interesting that the DC v. MD page doesn't include hours for medicine, pediatrics, emergency medicine, critical care, general surgery, etc.
It doesn't compare the admissions requirements, either. For a reason. ;)

http://www.chirobase.org/03Edu/adm.html
 

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As for the DO - their education (at accrediated schools) is absolutely and 100% equal. If they wish to market themselves as MDs - so be it. In every state, they enjoy the same unrestricted licenses as MDs.
Yes... the DO education is 100% equal and 99% identical. Let's keep our wrath focused on the NPs and especially the DCs ;)

I also got a good laugh from the "some medical schools do [require the MCAT]" line. Isn't there something like only one school in the Caribbean that does not?

Here's another gem: "However, D.C.s must teach courses in which M.D.s or D.O.s don't have sufficient education or practical clinical experience." :laugh:
 

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Is this legislation really necessary? Couldn't the problem be alleviated by doing away with the cryptic alphabet soup of abbreviations? Put Doctor of Medicine, Nurse Practitioner, Physician's Assistant, Registered Nurse, Doctor of Optometry, Doctor of Pharmacy, etc on name tags and stationary rather than MD, NP, PA, RN, DO, or PharmD which make no sense to the general public. It just takes an extra line on that name tag or lab coat - what's that a couple of extra bucks?
 

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PublicHealth said:
Waaaaa!...other people are called "doctors"...Waaaaa! (in my best Artie Lang impression). :laugh:
Waaaaa!...I'm 25 years old and going to die....Waaaaa!....I went to a chiropractor who told me he had more training than an MD and I believed him...Waaaa!...Now the low back pain he has been treating for 6 months is really an advanced renal cell carcinoma with mets!...Waaaa!...Why was he allowed to lie to me like that? (in my best impression of a real patient who did die in those circumstances) :(

- H
 

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FoughtFyr said:
Waaaaa!...I'm 25 years old and going to die....Waaaaa!....I went to a chiropractor who told me he had more training than an MD and I believed him...Waaaa!...Now the low back pain he has been treating for 6 months is really an advanced renal cell carcinoma with mets!...Waaaa!...Why was he allowed to lie to me like that? (in my best impression of a real patient who did die in those circumstances) :(
For a second there, I thought you were doing an impression of one of the 250,000 patients who die each year at the hands of an incompetent MD or DO: http://www.ourcivilisation.com/medicine/usamed.htm

Risk of stroke due to chiropractic adjustment is 1-3 per million: http://www.worldchiropracticalliance.org/positions/strokestudies.htm
 
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southerndoc said:
Interesting that the DC v. MD page doesn't include hours for medicine, pediatrics, emergency medicine, critical care, general surgery, etc. "Some" medical schools require a bachelors? "Some" medical schools require the MCAT? HA!

That was a funny laugh.

Alas, in my state, DC's and ND's are licensed by the state.
Old discussion:
http://forums.studentdoctor.net/showpost.php?p=2120101&postcount=47

- H
 

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Risk of stroke due to chiropractic adjustment is 1-3 per million:
That's like saying the guy who tries to cure cancer with crystals and magnets doesn't actually "kill" any of his patients.

And maybe he doesn't, technically... but I'm guessing that his outcomes are a little worse than those of a real oncology team, even if the surgical oncologist occasionally loses a patient on the table. It's errors of omission vs. commission.

DCs won't kill anyone because DCs aren't actually doing anything beyond pulling this or massaging that. But is that the guy you want to go to if you have renal cancer?
 

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PublicHealth said:
And your comments on these data (that were interpreted by a group of MDs and PhDs, might I add)?
Umm, given that they are my comments and interp and post, I'll leave the discussion in that thread "as-is".

- H
 

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PublicHealth said:
For a second there, I thought you were doing an impression of one of the 250,000 patients who die each year at the hands of an incompetent MD or DO: http://www.ourcivilisation.com/medicine/usamed.htm

Risk of stroke due to chiropractic adjustment is 1-3 per million: http://www.worldchiropracticalliance.org/positions/strokestudies.htm
From quackwatch.org: "Chiropractors would like you to believe that the incidence of stroke following neck manipulation is extremely small. Speculations exist that the odds of a serious complication due to neck manipulation are somewhere between one in 40,000 and one in 10 million manipulations. No one really knows, however, because (a) there has been little systematic study of its frequency; (b) the largest malpractice insurers won't reveal how many cases they know about; and (c) a large majority of cases that medical doctors see are not reported in scientific journals."
 

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southerndoc said:
From quackwatch.org: "Chiropractors would like you to believe that the incidence of stroke following neck manipulation is extremely small. Speculations exist that the odds of a serious complication due to neck manipulation are somewhere between one in 40,000 and one in 10 million manipulations. No one really knows, however, because (a) there has been little systematic study of its frequency; (b) the largest malpractice insurers won't reveal how many cases they know about; and (c) a large majority of cases that medical doctors see are not reported in scientific journals."
Doing a bit more reading will reveal that Stephen Barrett, the failed physician who maintains that quackwatch website, has lost a number of ugly lawsuits and has a "gag order" placed on him.
 

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Foughtfyr!!! You're back :)

Where have you been all this time?? I was starting to wonder if you ever going to reappear (no sarcastic tone intended). I look forward to discussing with you, and reading your coments any many issues!

To anyone else.. foughtfyr is a reasonable person to discuss facts with. Although him and I don't agree on some things (benifits of chiropractic for one), he has never ceased (sp?) to broaden my knowledge base.

Nice to see you back!
 

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PublicHealth said:
Doing a bit more reading will reveal that Stephen Barrett, the failed physician who maintains that quackwatch website, has lost a number of ugly lawsuits and has a "gag order" placed on him.
Actually, he won the lawsuits and has no gag order. And that is "retired" physician not "failed".

- H
 

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PublicHealth said:
Cop out. No surprise. :rolleyes:
WHAT?!? Seriously, WTF?!? I posted MY OWN comments and discussion, now I've "copped out" because I didn't comment further???

O.k., further proof that you, sir, are completely incapable of metered, reasoned debate.

- H
 
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billclinton said:
podiatry too.. for all those podiatrists who claim to have went to medical school
And the med students who claim to have done passed high school engrish?
 

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I think this legislation is very important and way overdue. I believe that there needs to be more regulations in hospitals when it comes to patients knowing who is actually a physician and who is not.

For instance in the several hospitals I have done roatations at; nurses, nutritionists, technicians, therapists, transport staff, secraterial staff, and Doctors all wear long white coats. medical students, pharmacy students, nursng students, respiratory therapy students, DPT and PT students all wear short white coats.

Medical students have traditionally worn short coats in order to differentiate themselves from Physicians; to alert patients and other health care staff that they are still in training.

I think we need to find some new way of marking who is a physician and who is not in the Hospital setting, one that doesn't boil down to any white male with a stethoscope being called doctor.
 

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foughtfyr.. what, no hello? Even after i took the trouble of coming on here and welcoming you back... NOt nice!

Nut seriosly.. my thoughts on this issue are easy. DC's went to chiro school NOT med school. As such, DC's should not be comparing there education to MD's and vice versa. I do feel many in the health care world severly under estimate the degree of "toughness" DC school really is. It's not a walk in the park by any means. With that said... i fully realize the degree of mental ability one must have in order to survive, and for that matter, get in to med school. If a DC ever told me they went to med school i'd laugh in their face and set them straight. Also, any DC who feels the need to compare their education to that of an MD unprovocted just has some sort of inferiority complex. DC's SHOULD be proud of their education. I know i'll be :)

As far as calling themselves doctor.. They (DC's) should! They have a doctorat. To me, that's a no brainer. I recall even foughtfyr saying many moons ago that he respects DC education but just doesn't subcribe to their belief system. I assume you were referring to the subluxation non sense. Correct me if i'm wrong.

Bye all
 

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PublicHealth said:
For a second there, I thought you were doing an impression of one of the 250,000 patients who die each year at the hands of an incompetent MD or DO: http://www.ourcivilisation.com/medicine/usamed.htm

Risk of stroke due to chiropractic adjustment is 1-3 per million: http://www.worldchiropracticalliance.org/positions/strokestudies.htm
ICU docs are dangerous too. You're hundreds, if not thousands, fold more likely to die in an ICU than in a primary care outpatient office

All critical care doctors should be burned at the stake
[/ridiculous comparison]
 

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FoughtFyr said:
WHAT?!? Seriously, WTF?!? I posted MY OWN comments and discussion, now I've "copped out" because I didn't comment further???

O.k., further proof that you, sir, are completely incapable of metered, reasoned debate.

- H
You would think that someone who has the screenname "PublicHealth" would be at least a little competent at interpreting epidemiological data....you'd be wrong....
 

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jesse14 said:
foughtfyr.. what, no hello? Even after i took the trouble of coming on here and welcoming you back... NOt nice!
Greetings, hope this post finds you and yours well.

jesse14 said:
Nut seriosly.. my thoughts on this issue are easy. DC's went to chiro school NOT med school. As such, DC's should not be comparing there education to MD's and vice versa. I do feel many in the health care world severly under estimate the degree of "toughness" DC school really is. It's not a walk in the park by any means. With that said... i fully realize the degree of mental ability one must have in order to survive, and for that matter, get in to med school. If a DC ever told me they went to med school i'd laugh in their face and set them straight. Also, any DC who feels the need to compare their education to that of an MD unprovocted just has some sort of inferiority complex. DC's SHOULD be proud of their education. I know i'll be :)
The debate is not how "tough" or "not tough" DC school is or is not but rather if a DC has the right to market that education as equal to or even superior to that of an MD/DO. That is a claim made by MANY DCs with internet based examples easy to find. The public simply doesn't understand the difference, with many truly believing that their chiropractor went to medical school.

jesse14 said:
As far as calling themselves doctor.. They (DC's) should! They have a doctorat. To me, that's a no brainer. I recall even foughtfyr saying many moons ago that he respects DC education but just doesn't subcribe to their belief system. I assume you were referring to the subluxation non sense. Correct me if i'm wrong.

Bye all
Call themselves "doctor", sure, they've earned the academic degree. Hold that out as the same as an MD/DO absolutely not!

- H
 

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611 said:
Are you saying it is legal for a DC ( or any non-MD for that matter) to say that he went to medical school when he did not? Is there a difference between "went to" and "graduated from". How about DO's who say they went to medical school? Technically, isn't it osteopathic medicine? Many DO's omit the DO after their name and just call themselves Dr. Many patients do not even know they are going to a DO.
But is it legal for a DC to say they "went to medical school"?
 

611

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FoughtFyr said:
Waaaaa!...I'm 25 years old and going to die....Waaaaa!....I went to a chiropractor who told me he had more training than an MD and I believed him...Waaaa!...Now the low back pain he has been treating for 6 months is really an advanced renal cell carcinoma with mets!...Waaaa!...Why was he allowed to lie to me like that? (in my best impression of a real patient who did die in those circumstances) :(

- H
True, but the same thing happens on both sides of the fence.
 

velo

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611 said:
But is it legal for a DC to say they "went to medical school"?
not if this law passes thank god.
 

611

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southerndoc said:
From quackwatch.org: "Chiropractors would like you to believe that the incidence of stroke following neck manipulation is extremely small. Speculations exist that the odds of a serious complication due to neck manipulation are somewhere between one in 40,000 and one in 10 million manipulations. No one really knows, however, because (a) there has been little systematic study of its frequency; (b) the largest malpractice insurers won't reveal how many cases they know about; and (c) a large majority of cases that medical doctors see are not reported in scientific journals."
Don't quote quackwatch, it hurts YOUR credibility.
 

611

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velo said:
not if this law passes thank god.
I don't see how it is legal for anyone to state verbally or in writing that they went to medical school if they did not. Any licensing board would repremand a practitioner for that type of behavior. It is probably a criminal offense as well to hold yourself out to the public to be something that you are not and hold no license for that.
 

QuikClot

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Marketing is a process of lying, exaggeration, fearmongering and distortion; no getting around that. You can prosecute people for claiming to be something they aren't, but for claiming to be better than someone else? Tough row to hoe.

Of course, we could declare medicine a marketing-free zone, in which there would be strict limits on self-promotion. In which case I'd start with the drug companies' stupid TV ads. DCs would be way down on the list.
 

velo

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jesse14

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wayttk said:
And who watches the Quackwatchers?

Holding Quackwatchers to their own standards- Data Please

http://www.randomjohn.info/wordpress/2005/12/29/data-please-holding-quackbusters-to-their-own-standards/

Wow, i didn't even know Barret failed his boards. This quote i found very interesting:
"some cases, I feel pretty strongly that pseudoskepticism is a serious disservice. I'm coming to this exact conclusion about the "Quackwatch" series of websites, and other efforts by Stephen Barrett and the NCAHF. As it turns out, Barrett has admitted, under oath, to failing the Medical Board certification exam in psychiatry, and, therefore, his qualifications as an "expert" are, at best, in serious doubt. His caustic attacks of all alternative medicine make his bias clear, and make his accusations of quackery ring hollow. His litigious nature and conflicts of interest as an "expert witness" (when the qualifications for such are lacking) really make me doubt his intentions as a consumer advocate and, quite frankly, throw the information on the quack/chiro/naturo/homeo/whateverelse-watch sites in doubt. I don't doubt that he's built up a case against a bunch of quacks, but I'd recommend corroborating any information found on these sites with a more trustworthy source of information before using them to make healthcare decisions"

Maybe these quackwatchers are the actual quacks...
 

AhhPuller

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Most Europeans call anyone with a doctorate "doctor," and they seem to have the necessary skill to differentiate a medical doctor from others with doctorates. I think this bill states that the American public are a bunch of idiots or are they scared that a NP with a Ph.D. will perform surgery? If they're scared of the latter, the bill won't do much to prevent it. But, then again, how often does that happen?
 
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