ewagner,
I believe I understand the direction you are coming from. I think that maybe the perception of our curriculm is like that of physical therapy. That may be one of the perceptions that could be better understood. To my knowledge it is not quite the same, though I am sure that there are parallel similarities. As I stated previously, our education has been gearing us toward PCP. Now I realize that this causes a stir for some people, but every direction has it's beginings and we are not there yet. Again, this is one good reason for conversation; to better understand what each other does.....
As stated: "To think that I (or you) could successfully manage a true anterior ligament tear without orthopedic surgical consultation is downright foolish."
Certainly, there are varying degrees of ligamentous tearing and to reitorate, I do refer for those requiring surgery; just as other doctors do. As you know, tears are not always either maximal or negligble; there is in between....
Stated: "But the standards of medical school simply weren't there."
I am not sure what you mean by standards. Those instructors who taught me pathology, were themselves MDs who also taught at the nearby med school. Many of our students studied at the med library, since the reference material was excellent and they had a great facility for having study groups.
It was not uncome for us to talk with the med students and exchange ideas and dialogue as to our curriculm. I had the opportunity to get to know several students and it was quite interesting, the similarities of our studies. There were many occasions when we would be studying the same material. I recall one time when a fourth year was looking at some notes I was copying at the copier. He said noted that he had had the same instructor for neuro path as I did (two different schools). He commented that they did not go into the depth that he saw us going into. On other occasions we experienced many other similarities. All of my diagnostic courses were taught by MDs.
Does this have any bearing on quality just because an MD taught it? No. My anatomy coursework was largely taught by a PhD in anatomy and my physiology was taught by a PhD in physiology. The instructor that picked up the difference had a PhD in Physical Therapy. She became a chiropractor, as she was impressed by our education. Did they challenege us? Absolutley, for that very reason.... because it would be assumed that we would recived a "glossing over" of material. Believe me, we did not.....
When you discuss "raising the bar", this is exactly what most schools have done. Those judging us, for the caliber of education, have perceptions based on the past. The problem, as I mentioned previously, is that we lack the residency program that would enable more hands-on experience. I admit this. But the caliber of classroom education would suprise many people.
Our clinic detail included a complete examination, all and any necessary blood/lab work (venipuncture), U/A, radiology with analysis, EMG, referral to local hospital for any necessary diagnositics we could not provide in house, as well as other procedures I may not recall. But, yes we have a ways to go...
Stated: "Neither a DC nor a PT will ever make life saving decisions."
I am not certain if the following qualifies as "life saving", but I would consider it such. Just to name a couple of serious cases.
One such was a female, ~56yoa. She presented with abdmominal pain. She had been to her GP, who Rx'd tagamet (back when it was popular).
She told me that her back was hurting and that she felt an adjustment would help. I examined her; auscultated, palpated and percussed all quadrants, found a loss of bowel sounds, dullness on percussion and hardness along the right costal margin, questioned her discovering rapid weight gain in the last few weeks. I surmised there to be a mass in near the right kidney. I referred her immediately to a surgeon, (who accepts direct referal from me) and he scheduled surgery; called me from the hospital to tell me that he reoved a large tumor that had grown into her kidney. He had to remove the tumor and kidney which was malignant. He thanked me for finding it, as did the patient, since it saved her life.
Another, which I recall, was a 60yoa male, with difficulty on urination with blood in urine. He reported having bouts of returns for urination. Lower back pain. On examination of the prostate, the sulcus was absent and hardness was palpable. Next did a sed rate, and specimen for PSA. Referred the patient. He is still living. Does that qualify as life saving? I don't know......
Numerous others, but just giving you a sampling of some of the work I do so as to better understand. I am both trained and licensed to do so, in case there is a question again of practicing medicine w/o a license....
Curious to know if those protocals are taught in Physical therapy? I don't know.
Stated: "...I would actually say anti DC
direct access (meaning without physician referral)."
The very understanding you raise, would demonstrate the reason that MDs and DOs need to be better informed as to what we do. From what I was able to glean, from earlier conversations here, there are some perceptions that our knowledge is soley of the spine and that we "crack bones." I would like to enlighten a few so as to correct that perception.....
Being POE doctors does not mean that we treat all complaints or conditions. It means that we are able to differentiate those complaints that we treat from those we refer.
I know of two ER doctors that know to refer to me for certain neck and spine injuries, as that is what I treat. There is a local OB/GYN clinic that refers expectants to me to address SI and lumbar spine compliants as well as cephalgia.....
Not everything is crisis care for me. Nor is it for many GPs...
I enjoy being able to address the questions.
