Thoughts about Chiropractic

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PublicHealth

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What are your thoughts about chiropractic? What is the relationship, if any, between chiropractic and osteopathic medicine? Similarities? Differences?

I have read a bit about chiropractic, and it seems like a promising career path for individuals interested in manipulation and nutrition therapy. Chiropractors also make pretty good money, too. Thoughts?
 
you might do a search. there were a couple of heated threads about this not so long ago.


BTW: there are way more differences than similarities
 
I think that there are some sincere chiropractors out there. However, they have some questionable procedures, practices that seem to make me question them. Also, I've heard that they take a course in marketing, to sell their service. That seems odd to me. It's about getting clients to continually come back. Also, I have heard that they use x-rays as a means of determing if you have one leg longer than the other. If you shift and take the x-ray in a different position you could easily show that that there has been some change. I just think some of it is questionable.
 
Originally posted by PublicHealth
What are your thoughts about chiropractic?

I have no problem with Chiropractors acting like Chiropractors.

It's when they want to act like physicians that I have an issue.
 
Got a funny experience....


My mother calls me and tells me that she needs to go to a Crack-toe-pactor and I said, "Chiropractor? since when did you start doing that?"

She blah blah blahed

and I said well why do you go to this local DO that practices OMT exclusively, she will really take care of all the pains, I am sure...

she proceeded to ask what OMT was.... I explained and she was still confused....

in anycase it is a bit of the craps if you ask me

God Bless

DrDad
 
Originally posted by JPHazelton
I have no problem with Chiropractors acting like Chiropractors.

It's when they want to act like physicians that I have an issue.

Where is the line drawn?
 
I draw the line when they say the want to be a primary care provider. That should be exclusively the realm of the DO/MD.
 
I agree with the others about them trying to call themselves physicians--that chiro's are nuts. The government is even nuttier if they allow them to do so. I believe the newest issue of The D.O. has an article about chiro's trying to be considered as physicians. I think that if they want to do that, they better have a standard med school curriculum for 4 years and have to go through rotations and residency just like DO's and MD's do. Osteopathy vs. chiropractics--taught at my school is that OMT helps to get better joint articulation and freedom of movement past the restriction (which is preventing normal motion), and that chiropractics tries to achieve perfect alignment of the vertebral column itself, regardless of freedom of motion. Does anyone know how chiropractors are taught to diagnose, anything similar to how DO's do it? Also, I knew someone who was early acceptance into a chiro school. All he had to do to maintain that standing was keep a 2.0 or greater GPA in undergrad (no MCAT either). I just don't think they should get the physician title. They are not physicians.
 
Good point. Admission standards to Doctor of Chiropractic (D.C.) programs seem to be quite lax. Most chiropractic schools want students to maintain, as you mentioned, 2.0 to 2.5 GPAs. Some of the better schools want 3.0 GPAs. Interestingly, neither the MCAT nor GRE are required at most programs. Here's a typical list of prerequisites: http://www.nycc.edu/apply.asp

For students interested in alternative medicine, chiropractic is a viable and potentially lucrative career path. However, chiropractors should not, as stated above, be considered primary care practitioners. Reasons include their not be licensed to prescribe drugs or perform surgery, their not having to complete a residency, and their being considered an alternative to mainstream healthcare. That is not to say that chiropractic does not fulfill an important health need in the US. Millions of patients swear by chiropractic, and many physicians, MDs and DOs alike, have embraced chiropractic as an important ancillary treatment for patients with a range of musculoskeletal and related problems. Check out this site for more information: http://www.amerchiro.org/

PH
 
i think they definitely have their place in medicine if that's what patients want (and lots do), but i'm a bit apprehensive after seeing so many people get cervical fusions, and talk about how they went to the chiro for ages after they were injured instead of their primary doctor. some of those might not have needed surgery had they not waited. no thanks!
 
Not to go on a rant....

It seems that most people when asked what Osteopathy is, actually define it as being a profession that is defined by Osteopathic manipulative treatment. However, Osteopathy defines OMT and not the other way around. A.T. Still's tenets never made actual mention to OMT, although he did develope the foundations or principles that define Osteopathy as a whole and therefore, the development of OMT was based on these principles. People need to understand that OMT is one particular facet of Osteopathy and that it by far and large does not fully define the totality of the Osteopathic profession.

Saying that a chiropractor is an "equivalent" of a D.O. is ludicrous. Perhaps in the sense that some of the techniques and reasoning of OMT are similar to the methodolgy behind chiropractic techniques, then maybe a chiropractor and D.O. do handle particular modalities of treatments in a similar fashion.

The proverbial line should be drawn for a chiropractor when the underlying somatic dysfunction is not purely musculo-skeletal in nature. Any pathological condition that has sequlae that cause somatic dysfunction should and I am sure would be more appropriately handled by a physician who is more learned in the underlying pathognomic conditions.

It is in my opinion that the general public has an understanding that D.O.'s predominantly use OMT in their treatment plans. However, I am not quite sure that this is entirely true. I understand and appreciate OMT for what it is and its potential, however, as Osteopathic physicians, our defining feature lies in how we approach the patients that we care for and how we think about the underlying disease in the context of our patient's complex lifestyles.

Only by educating the general public as to the underlying principles of Osteopathy as a whole, D.O.s will be able to be more accepted as clinicians and not some form of a musculo-skeletal manipulator....
 
Originally posted by medic0129
Not to go on a rant....

It seems that most people when asked what Osteopathy is, actually define it as being a profession that is defined by Osteopathic manipulative treatment. However, Osteopathy defines OMT and not the other way around. A.T. Still's tenets never made actual mention to OMT, although he did develope the foundations or principles that define Osteopathy as a whole and therefore, the development of OMT was based on these principles. People need to understand that OMT is one particular facet of Osteopathy and that it by far and large does not fully define the totality of the Osteopathic profession.

Saying that a chiropractor is an "equivalent" of a D.O. is ludicrous. Perhaps in the sense that some of the techniques and reasoning of OMT are similar to the methodolgy behind chiropractic techniques, then maybe a chiropractor and D.O. do handle particular modalities of treatments in a similar fashion.

The proverbial line should be drawn for a chiropractor when the underlying somatic dysfunction is not purely musculo-skeletal in nature. Any pathological condition that has sequlae that cause somatic dysfunction should and I am sure would be more appropriately handled by a physician who is more learned in the underlying pathognomic conditions.

It is in my opinion that the general public has an understanding that D.O.'s predominantly use OMT in their treatment plans. However, I am not quite sure that this is entirely true. I understand and appreciate OMT for what it is and its potential, however, as Osteopathic physicians, our defining feature lies in how we approach the patients that we care for and how we think about the underlying disease in the context of our patient's complex lifestyles.

Only by educating the general public as to the underlying principles of Osteopathy as a whole, D.O.s will be able to be more accepted as clinicians and not some form of a musculo-skeletal manipulator....

:clap: :clap: :clap:
 
I second that...

:clap:

We need intelligent, well spoken people like yourself to represent osteopathy. Thanks for your comments, medic0129.
 
I seriously can't believe that anyone is trying to compare a chiropractor to an osteopath.
One of my best friends is a chiropractor (even owns her own successful practice) and saying they are like DO's is like comparing a lab tech to a pathologist.
I don't know if that made sense, but I get too fired up on the issue to think straight.
My friend, by the way is choosing NOT to immunize her own child! Does that sound very osteopathic to anyone???
 
I think that like any other group, lumping chiropractors into one general category excludes some. My father is a chiropractor and now I am a first year DO student. I understand that my opinion is probably biased, but I think that many of my fellow DO students do not realize the advantage that we have in terms of our relationship with DCs. Granted my only interaction with a DC is my dad (so what I know comes from one source), I can say that he openly admits that his practice is limited. A vast majority of the patients that come in to his office do not have a family physician, or he has patients that he realizes will not benefit from his services. In such situations he exclusively recommends that his patients see DOs.
I guess that my point is that you are stupid if you ever burn any bridges, you never know when someone will be in a position to help you. Even if you think that DCs are full of crap, a large portion of the American population doesn't. And in the end we should all only care about what makes the patient better.
I have no problems with people that disagree with me, but at the same time I think that you should realize that you never know where your next referral is coming from.
 
So, you're saying that even if something is "Full of Crap" we should be willing to endorse it for the money? I think if we believe that Chiropractors are limited, misleading and perhaps even harmful we shouldn't support it. If we support every snake sales man that comes down the road because we might get a referal from them are we truly looking out for the benefit of our patients.
Your referal reasoning is truly insulting because it's tied to money and not patient care.
 
Originally posted by EUROdocMOM
I seriously can't believe that anyone is trying to compare a chiropractor to an osteopath.
...saying they are like DO's is like comparing a lab tech to a pathologist.
I don't know if that made sense, but I get too fired up on the issue to think straight.
I don't understand why everyone is getting so fired up about this.

DC's and DO's are essentially trying to get to the same end by somewhat similar/different means. They both work on the principle that if you fix the body structurally then everything else should fall into place functionally. Both realize that this is not only true on the gross musculoskeletal scale but on the microscopic pharmacological scale as well. It's just that the osteopaths accept that this principle can be applied to allopathic medicine, pharmacologically and surgically. Whereas, chiropractors choose to reject and distance themselves from conventional medicine and see the answer lying in the more natural/herbal path.

Yes, there are obvious philosophical and technical differences between the two, but a true osteopath realizes that there is not always one answer to one problem.
 
http://www.skepticfiles.org/skep2/chiroqak.htm

For nearly a hundred years chiropractors have insisted that spinal
misalignments can cause and/or aggravate a wide assortment of diseases by impinging on nerves as the exit the spine. According to chiropractic theory, this impedes the flow of "vital energy" (often called "Innate Intelligence") to organs and tissues throughout the body.

However, instead of doing scientific studies to test beliefs like these, chiropractors have relentlessly waged what Consumer Reports has called a "war with science." (Consumer Reports, 1975) Thanks to victories in legislatures and courts, their number, priviliges, and income continue to grow, even thouugh their underlying theory has been thoroughly discredited. (Crelin, E. "A Scientific Test of the Chiropractic Theory", American Scientist, 1973)

The medical profession, concerned about chiropractic's dangers, shunned chiropractors and did its best to educate legislators and the public about chiropractic's absurdities and dangers. But intense lobbying enabled chiropractors to become licensed as independent practitioners in every state, gain inclusion under Medicare and many other insurance programs, and achieve the freedom to shower the public inappropriately with x-rays.

There is no evidence that subluxations as defined by chiropractors
exist, or have any clinical significance, or that chiropractors can
agree on what x-ray features signify a subluxation. Yet Medicare covers chiropractic patients only for treatment of "subluxations demonstrated by x-rays to exist."

The x-ray in the hands of some chiropractors is like a horoscope in the hands of an astrologer. But at least astrologers don't dose clients with radiation.

As with astrology, chiropractic has established no scientific standards. There is a wide range of philosophy, theory, and practice. Some believe that their professional role is to detect what they call "subluxations" and to adjust and correct them. Even spinal adjustment techniques vary widely. There are dozens of different methods, none of which has been
scientifically validated or proven better or worse than the rest.

Despite wide variations, most chiropractors adhere to the following false tenets:

1. The human spine is subject to frequent and significant misalignments ("subluxations") from a wide variety of causes, including practically all simple daily activities. Even malnutrition, air pollution, cigarette smoking, and pesticides in food can aggravate subluxations.

2. Subluxations interfere with the normal flow of "nerve energy". This causes or aggravates malfunction of the organs and tissues that they supply, and can cause disease and death.

3. Spinal manipulations ("adjustments") can fix misalignments, thereby normalizing the flow of nerve energy and restoring normal nerve function and normal organ and tissue function.

4. Chiropactors have a unique ability to diagnose and correct spinal subluxations. These lesions can cause or aggravate no only pain but practically every health problem known to humans. Among those specified in widely distributed pamphlets and books are heart disease, cancer, asthma, hypertension, rheumatoid arthritis, hyperactivity, sinusitis, colds, and emotional, neurological, gastrointestinal, and skin disorders.

Chiropractic resembles religion more than science. Many chiropractors believe in a force or power they call Innate Intelligence. It is, they say, unmeasurable, but chiropractors are nevertheless certain that their manipulations and adjustments facilitate its flow and thereby enhance health.

Chiroprators don't even know whether their manipulations increase or decrease impulses in the nerves they claim to be helping. Dogma would seem to dictate that adjustments always increase impulses, since the purpose is to free up blockages. But in cases in which manipulations do appear to reduce chronic pain, impulses may be reduced, not increased.

In 1976, Chester Wilk and four other D.C.'s charged that the American Medical Association (AMA) and more than a dozen other organizations had violated the Sherman Antitrust Act by trying to eliminate their profession. In 1981, a jury sided with the AMA, but an appeals court overturned the decision on procedural grounds.

Under antitrust law, it turned out, scientific truth had little
relevance. In 1987, federal judge Susan Getzendanner ruled that the AMA had engaged in an illegal boycott. Although she concluded that the dominant reason for the AMA's antichiropractic campaign was the belief that chiropractic was not in the best interest of patients, she ruled that the AMA had gone too far.

Chiropractors trumpet the case as an endorsement of their methods. But it was not. Close reading of the judge's opinion shows she had little regard for chiropractic itself. She noted, for example, that during the 1960's "there was a lot of material available to the AMA Committee on Quackery that supported its belief that all chiropractic was unscientific and deleterious." In a dubious exercise of judicial logic, she ruled that chiropractic's shorcomings did not justify attempting to contain and eliminate an entire licensed profession without first demonstrating that a less restrictive campaign could not succeed in protecting the public.

The Court of Appeals said, "Neither the district court, nor this court is equipped to determine whether chiropractic is scientific or not." In other words, the defendents (AMA) were deprived of their main defense because the judges refused to judge the merits of their argument. Our society may pay dearly for the courts' self-imposed scientific illiteracy. Moreover, other dubious healers may be free to follow in the chiropractors footsteps. For example, if state legislatures legitimize astrological medicine because of pressures from local astrologers, antitrust laws could make it difficult for medical organizations to prevent astrologers from participating in insurance programs and gaining hospital privileges. This is essentially what happened with chiropractic.
 
First of all, I would like to start by saying that I am a friend and classmate of BPlato. But we also have quite opposite opinions of OMM. Basically he likes it and I don't. But to each their own.

Also, for the poster that thinks he is just thinking about getting referrals to make money, you cannot be further from the truth. When you are working in the real world, all physicians have to be careful what they say about other healthcare practitioners. Burnt bridges aren't only about the allmighty $. They have more to do with working relationships. But you also have to remember that with no patients, a practice will not survive.

Enough about that though......I also wanted to point out that Buster Douglas said there are different philosophical and technical differences between DC manipulation and Osteopathic Manipulation. Actually, I am told by two DC's who go to school here, ( one is also an MS-I and my lab partner), that Osteopathic manipulation is exactly the same as chiropractic manipulation. Although, we do learn more techniques.

The biggest thing that I want to point out is that we are physicians. Manipulation is just a tool that we are taught and we have the choice to use it or not. But it is just a tool. Not the focus of what we are doing. Unless one chooses to specialize in OMM.

So that being said, I have no problem with chiropractors. Just like I have no problem with physical therapists, diabetes counselors, genetic counselors, naturopathic physicians, healers, and snake oil salesman. In the end, I will just be concerned with treating my own patients to the best of my ability. Oh.......I DO have a problem with insurance companies though!!!!!!!
 
Anyone encounter DOs and DCs practicing together in private practice? If the two fields complement one another, one would think that this would be profitable for both patients and practitioners. It would also make sense to staff some physical and occupational therapists. This would likely offer patients the most comprehensive treatment and rehabilitation. Of course, hospitals can take care of these needs, too.
 
I don't think that would be likely. First, because the DO would not need a DC because he or she could treat any dysfunction themselves. And second, the DO would probably be more inclined to refer to another DO if they did not utilize OMM.
 
What is the problem with insurance companies? Is it that they are increasingly likely to cover chiropracter fees? Having once utilized DC's what is with their typical "shotgun" method to manipulation, while we use a more localized approach? What are the differences in manipulation?
 
Although chiropractics can't prescibe medication they treat a lot of musclesketal problems using advanced equipment and other manipulation technique. As a result of their extensive advertising public come to them for back problems etc...I personally know one highly successful chiropracter who see many patients. He works about six hours and makes more money than average physician! I think the problem is that MANY osteopathic physicians stay away from manipulation and the distinction between MD and DO is very slim as they work in managed care environment. I feel that as a DO we have responsiblity to our patients and duty to our profession to incorporate OMT into all of our medical practice. Instead of making fun of chiropracters' credentiasl or beliefs we should improve ourselves to "steal" the patients from them.
 
You are all very ignorant about what chiropractic is or is not. Comparing us to snake salesman and astrologers is foolhardy and childish. I don't know exactly where all of the resentment from DO's comes from, but most of us DC's are sound, intelligent, rational gateway providers that would gladly refer to you guys if you would stop bashing us! It is prob. the fact that you think we "stole" manipulation from you guys which has no truth to it.
As far as you having a problem with us "being primary care providers" it is double-edged sword. If we don't diagnose and just manipulate we get bashed for being quacks who weren't aware of probs a patient had that might contraindicate manipulation. If we do dx, we are considered wanna be DO/MD's we can't win. Just so you know, most MDs have more respect for DC's than you do. I have one working in my office. Any questions or comments feel free to pm me. Until then keep on bashing out of ignorance!!!

BMW, DC
 
As far as you having a problem with us "being primary care providers" it is double-edged sword. If we don't diagnose and just manipulate we get bashed for being quacks who weren't aware of probs a patient had that might contraindicate manipulation. If we do dx, we are considered wanna be DO/MD's we can't win.

I guess I wouldn't have a problem with it so long as you make explicitly clear to each and every one of your clients that your care in no way substitutes for that of a board-certified MD/DO.
 
<b>Good</b> DC's, <b>good</b> DO's and <b>good</b> MD's are all trying to achieve the same thing--relief and good-health for their patients.

When you realize that there's a "mode of treatment" that works without side-effects, without invasion of the body and for every disease known. The <i>placebo effect</i> is well-know and experimental tests are structured to eliminate, account and out-perform the placebo effect.

Osteopathy evolved because the the danger inherent in drugs of the late 1800's, the surgical practices of the time and lack of understanding of how the body heals itself. Until the early, 1900's DO's did not prescribe medicine or perform surgical procedures (very similar in philosphy to DC's of today).

Obviously, things have changed as MD's are not nearly as dangerous as in the late 1800's ;-) DO's are full physicians--who in addtion to prescribing medicine and performing surgical procedures, practice OMT. DC's practice a similar technique as DO's but they do not prescribe or perform surgeries. DO's however approach manipulation from a different philosphy and understanding than DC's.

Good DC's perform in their area of expertise. Good MD's perform in their area of expertise. And, good DO's perfrom in their area of expertise. If outside their area of expertise, they refer to someone else who can help their patient.

I know from personal experience, that there are some outstanding DC's, DO's and MD's out there. I also know that there are some "quacks" :-(

We had a case where a DO, who was obviously out of practice, attempted a OM procedure on a volunteer student. As a result, she was in severe pain...it took almost an hour of treatment by an experienced and OMT practicing DO before she was "okay".

It's too easy to make generalizations about a profession based on the actions of a few. The goal for us should be getting the patient the care they need to as quickly and as cost-effectively as possible.

Sometimes surgery is not needed. Some times drugs are not needed. Sometimes manipulation is not needed. Sometimes all we need to do is show some human compassion and touch the patient with care and concern. But we know a bit more than we knew back in the late 1800's--the only thing is we don't know it all yet ;-)
 
Sometimes surgery is not needed. Some times drugs are not needed. Sometimes manipulation is not needed. Sometimes all we need to do is show some human compassion and touch the patient with care and concern. But we know a bit more than we knew back in the late 1800's--the only thing is we don't know it all yet ;-)

😉 Thanks HokieDO !!! Yours is a voice of reason, and it sounds like you will be an excellent physician, because you are concerned with the patient's healing, no matter which paths the patient may explore to reach the goal.

I think different disciplines have much to teach each other and much to learn from one another. When information is shared, the one to benefit the most is the patient.

Also, did your opinion of OMT change as a result of what you witnessed with the student? Did things turn out ok?
 
😉
Sometimes surgery is not needed. Some times drugs are not needed. Sometimes manipulation is not needed. Sometimes all we need to do is show some human compassion and touch the patient with care and concern. But we know a bit more than we knew back in the late 1800's--the only thing is we don't know it all yet ;-)
 
How about this one. My long time friend who has been going to a chiropractor for many years now has his wife going. Whatever. I asked them who their PCP was and they said their doctor who is a D.C. Hmmm I said. The conversation later lead to myself inquiring about their 13 month old child and her physician. Guess what? The baby girl also has the chiropractor as her doctor. A 13 month old baby being cracked. Is this mind boggling or what? I just do not see how that is right.
 
As far as MD/DO's respecting chiropractors, it must be regional or, more likey related to the individual. Most chiropractors I know are slimeballs. One in my area dressed up like Superman to attract business, the other is like a telemarketer who calls his friends families to try and drum up business. Best yet: my father had massive disc degeneration in C2-C5 and had a laminectomy, which entailed a neurosurgeon replacing the lamina with titanium. The chiropractor, whom I babysat for, asked how my Dad was doing.... when I told him of the situation, he promptly told me that my Dad should have come to him first!! He swore up and down that he could have fixed my father.... what do those damn neurosurgeons know anyway???
🙄
 
Outside of the United States, the differences between chiropractors and osteopaths start to melt away... to the point where the average patient wouldn't be able to tell the difference but for...

...osteos use soft-tissue techniques more often
...chiros generally (but not universally) take x-rays (mostly as a precautionary measure, but sometimes - rather unscrupulously IMHO - to play the Big White Doctor)
...chiros tend to (but not always) 'over-treat' or at least treat more often than osteos.
...chiros tend to (but not always) employ a lot more rhetoric and Real Estate Agent-like sales tactics.
...osteos tend to spend longer with each patient.
...osteos have a reputation that is less 'Wham! Bam Thankyou Ma'am! than their chiropractic cousins.

Non-American osteopaths are limited to OMT and have equal legal status to chiropractors. (People start getting confused when you tell them American osteos are like ordinary doctors who sometimes use manual therapies! Although they think it's a good thing by and large.)

Royal Melbourne Institute of Technology even has osteopathic and chiropractic students training side-by-side (although the therapeutics and 'philosophy' classes are separate). Both professions profess to be 'natural' neuromusculoskelatal specialists. It has to be said that both are very trained in this respect... and the emphasis on science seems to be improving with time.

The lack of access to hospitals is a continuing issue and one without an easy solution, although the number of partnerships between medical, physiotherapy, chiropractic and osteopathic practitioners are growing.

There are plenty of chiropractors who don't fit the stereotype and who are, quite frankly, embarrassed by their less 'humane', less scientific, more commercially-oriented colleagues. They aim to treat the whole person and manage (or co-manage with other health care professionals) a range of pain syndromes and musculoskeletal problems, as well as some systemic disorders via manual treatment - mostly spinal adjustments (BTW it was A.T. Still who first used this term to refer to manipulation). All Australian chiropractors and osteopaths are taught to work within the established health care system and to refer where necessary.

The research profile of manual and physical medicine has improved immensely over the last few decades - thanks in no small part to the work of chiropractic scientists. While more than a vocal few chiropractors tend to spout unscientific pseudo-religious rubbish, the situation is improving.

There is a wealth of useful stuff that chiropractors and osteopaths/osteopathic physicians can learn from each other.

A good account of where chiropractic stands today, its scientific research and where the profession is headed is David Chapman-Smith's 'The Chiropractic Profession.'

Best not to throw the baby out with the bathwater.

(Oh, and Raptor 5, I know plenty of kids much younger than 13 months who receive spinal mobilisation/gentle manipulation to good effect and - to my knowledge - little or no ill-effect. I know a chiropractor who works with a local maternity and childrens' hospital.)
 
Originally posted by haujun
I feel that as a DO we have responsiblity to our patients and duty to our profession to incorporate OMT into all of our medical practice.

🙄


Originally posted by HokieDO
Sometimes surgery is not needed. Some times drugs are not needed. Sometimes manipulation is not needed. Sometimes all we need to do is show some human compassion and touch the patient with care and concern.


:clap:
 
Can anyone post any research that has been done on the effetiveness of chiropractic manipulation in treating anything other than musculo-skeletal pain?

I've had friends with back pain see chiropractors constantly and not feel any better. Why didn't the chiropractor talk to them about stregthening exercises, weight loss, and all the other things that can help prevent back pain? I'm very skeptical of any profession that makes alot of claims and doesn't back them up with good scientific research. Just because alot of people go to them doesn't mean it works.

The basis for their profession is really far fetched; unless there is some real evidence supporting their claims I would never refer a patient or anyone else to a chiropractor.
 
Originally posted by Vesalius
Can anyone post any research that has been done on the effetiveness of chiropractic manipulation in treating anything other than musculo-skeletal pain

I doubt it.
 
You know, every profession has it's "skeletons in the closet"...no pun intented...so to speak. It seems that if more DO's were practicing manipulation, there would be more people looking to DO's for musculoskeletal problems, but considering it is nearly impossible in most areas to find a DO that uses manipulation, people are having to resort to chiropractors. I have worked in a chiropractic office as a massage therapist, and although I have decided to go DO due to my own beliefs and need for a certain scope of practice, chiropractors are definitely helping people. As long as the chiropractor is intelligent enough to refer out when a complication arises, there seems to be no problems with injury in my own experience.

I haven't worked with any of the chiropractors who consider themselves primary care docs, but from what I understand, schools like northwestern in chicago, and Western States in Portland, are over training their chiropractors in primary care, and undertraining them in manipulation, so when they graduate, there are few states that allow them the scope of practice they were trained in.

I have to adress the last reply in that there is no research toward things other than musculoskeletal. Musculoskeletal is the main objective of chiropractic work, so I think that most research obviously points in that direction. I have watched the psyche change of many patients once their pain was gone, and if the physicians can't take care of the pain outside of pain meds, which is another huge topic for me, then the patients either have to live with pain, or undergo surgery which can cause more complications and pain than the original problem ( in some cases, I am trying not to speak in extremes.)
Give the chiropractors a break, they aren't going to be in primary care...at least not anytime soon, in fact there are some serious problems in the internal structure of chiropractic philosophy between the straight chiropractors who treat musculoskeletal only (vertebral subluxations) and the "mixers", who use every method they can including primary care type methods. The philosophies are very different and the motives between the two are causing quite a conflict.

Anyway, there is tons of research and info on all of this if you are truly interested in educating yourselves instead of putting another profession down while being ignorant about what is truly going on. Here is a link that shows research going on in chiropractic....Just remember, we are all becoming physicians because that is what we believe in, osteopathic at that, and it hurts us when others don't consider us real doctors, so take a bit of your own medicine, and leave the chiros alone, they have enough battles to fight....(sorry this is so lengthy, but this thread has been going for a while...)

http://www.chiro.org/research/ABSTRACTS/Articles.shtml:

Peace...😎
 
For nearly a hundred years chiropractors have insisted that spinal misalignments can cause and/or aggravate a wide assortment of diseases by impinging on nerves as the exit the spine. According to chiropractic theory, this impedes the flow of "vital energy" (often called "Innate Intelligence") to organs and tissues throughout the body....

Guess what? The baby girl also has the chiropractor as her doctor. A 13 month old baby being cracked. Is this mind boggling or what? I just do not see how that is right.

Anyone ever heard of Robert Fulford, DO? He wrote a book called Touch of Life that discusses osteopathic philosophy (including energy flow in the body and the use of OMM to improve and restore said flow) and his experiences in his practice, which was based solely on OMM. Towards the end of his career, he would only work on children because he felt that is they benefited the most from his efforts.

Perhaps before we rant and rave about what chiropractic is and is not, we should look into the history and philosophy of osteopathy so we can speak from an informed (and hopefully intelligent) position...
 
Originally posted by wholehealth
.It seems that if more DO's were practicing manipulation, there would be more people looking to DO's for musculoskeletal problems, but considering it is nearly impossible in most areas to find a DO that uses manipulation, people are having to resort to chiropractors.

There's no money in manipulation. That's the bottom line. Most of the DO FPs I've rotated with barely use it because it takes too much time, and when you're an FP...time is money!
 
Originally posted by HokieDO
[BWe had a case where a DO, who was obviously out of practice, attempted a OM procedure on a volunteer student. As a result, she was in severe pain...it took almost an hour of treatment by an experienced and OMT practicing DO before she was "okay".
[/B]

Bad outcomes with OMM are not usually related to the practicioner at all. It's impossible to know what a patient's reaction to OMM will be. I've seen some OMM jedi masters...OMM faculty types...people who have OMM-only practices....I've seen these people "hurt" patients.

Again, you can never really predict how a patient will tolerate a technique. It's really hard to hurt someone with OMM...more than likely it wasn't this guy's fault.
 
Originally posted by Teufelhunden
There's no money in manipulation. That's the bottom line. Most of the DO FPs I've rotated with barely use it because it takes too much time, and when you're an FP...time is money!

If you are good at OMM, it does not take that much time. I have watched skilled omm therapists that can diagnose and adjust in less than five minutes. Maybe we're not getting enough practice in classic OMM training at school, or maybe many of the DO's don't see themselves practicing OMM, so they don't pay enough attention to become skilled at it. 70 = DO, right?? Well, I don't like that phrase because I would never want a 70 DO to manipulate my spine. Some people are truly gifted at this type of work, and can do it without too much time cost. I don't know how there can't be any money in it knowing that my chiropractor took home almost 200K last year and only worked 3 days per week, no call. Wouldn't insurance pay more for DO manipulation than for DC adjustments?

Anyway, back to my point that there is a need for muculoskeletal work due to the low activity lifestyle most American's lead, and if the DO's can't do it for whatever reason, people will resort to chiropractic. We should just let them do their job and stop ridiculing their philosophy especially if we don't understand it.
 
vesalius,

I suppose when a DO does a manipulation there is all sorts of research and evidence about it's effectiveness, but when a chiro does it they are quacks who are practicing voo-doo. The double standard is glaring. I would think you would be more open minded considering that you are in a profession that is also scrutinized very closely by your sibling MD's.

BMW-
 
Originally posted by BMW19
vesalius,

I suppose when a DO does a manipulation there is all sorts of research and evidence about it's effectiveness, but when a chiro does it they are quacks who are practicing voo-doo. The double standard is glaring. I would think you would be more open minded considering that you are in a profession that is also scrutinized very closely by your sibling MD's.

BMW-

All physicians, MD and DO, tend to scrutinize the practice of medicine b/c the scrutiny results in the elimination of useless/harmful practices and, ultimately progress. Those with nothing to hide and pure intentions will never fear scrutiny.

At several institutions OMT is being subjected to the scrutiny of evidence based research. This is being done with public funds, with complete documentation that is publicly available. Why? Because the profession seeks to progress for the good of the patient.

So the appropriate response to the first sentence of your statement is: Yes and yes.
 
Originally posted by Vesalius
Can anyone post any research that has been done on the effetiveness of chiropractic manipulation in treating anything other than musculo-skeletal pain?

This is a little perplexing coming from a DO student...

The efficacy of manual therapies, inc. chiropractic manipulation (which is, in effect, no different to HVLA OMT) as a treatment (ancillary and sometimes, albeit rarely, primary) for a limited range of systemic or type-O disorders is now pretty well documented.

Suggestions for literature to start with include: Journal of Manipulative and Physiological Therapeutics, Journal of the American Osteopathic Association, Foundations for Osteopathic Medicine, The Chiropractic Profession, The Principles and Practice of Chiropractic, etc.

Now, this isn't to say that many chiropractors (and some osteopaths) exaggerate the efficacy of SMT - because they frequently do.

It's also not to say that SMT/OMT is cure-all, because it simply isn't.

And neuromusculoskeletal pain syndromes are by far and away the thing that chiropractic and OMT treats best.

The scope of practice for the manual and manipulative therapies is still being defined, and the role of the NMS system in health is grossly under-researched, but it's come a long way... and you have to give the chiropractic profession a lot of credit for that.
 
My cousin is a chiropractor, and while he is a super nice guy, he makes no secret of the fact around the family, that his private practice is primarily a business, and that he does all sorts of things just because he can bill them. He took marketing classes in chiropractic college and admits to positioning patients in different ways to "exaggerate" x-ray changes (i.e. longer leg syndrome). Of course he says he just does that to make it easier for the patient to see if they want to view their own x-rays.
I went to a chiropractor about 3 or 4 years ago after a car wreck. Big mistake. Billed the insurance company for about 4 grand, and all he did was pop my back the same way every time, took a ton of xrays, and gave me some icy hot. Oh yeah, and a TENS unit that he billed several hundred dollars for. I mentioned that I was going to attend medical (osteopathic) school in the future. He groaned and rolled his eyes, and told me that he hoped I wasn't ever going to get the idea that a DO could do what a DC could do. He said, DO's only get to "manipulate" while the true DC could "adjust". Told me he thinks DC's should be able to practice primary care because he got "just as good of an education as any DO or MD". My cousin thinks the same way. He thinks because he jacks people out of money (to the tune of about $300k/yr), he has got it made. Prides himself on not refering patients to MD/DO because as he puts it, "chiropractic fixes your problem, not just treating it". He's my cousin, and again, a really nice guy, but he's a snake oil salesman in office. Selling whatever he can con people into buying. Not what I envisioned as a integral part of a cohesive, healthcare system.
 
The problem with chiropractors in the United States is variability.

Some are great chiropractors, NMS specialists who know the limits of their practices and will refer patients to medical doctors for conditions out of their area of expertise.

Then there are some who will try to keep the patients coming back (weekly spinal health screening), do not know the limits of their knowledge, and pretend to be primary care physicians. Some may even try to convince the patients that the medical establishment is out to get them and that medicine is EVIL (and vaccination is evil).

Examples of both types were posted in this thread.

As a physician, when you refer someone to a chiropractor, you don't know what type of chiropractor your patient will see. Physicians will hesitate to refer their patients to chiropractors that they do not know (have no past dealings with).

From what I have heard, chiropractors outside the US (in Canada, UK, Australia, etc) are more standardized and less commercial in nature (no spinal screening in malls). They are also more uniform in nature so a physician won't have to worry about the type of chiropractor his/her patients will see.

I think if chiropractors want to bridge the gap/distrust between medical and chiro, they have to start policing themselves and start eliminating the variability.

That's my $0.02
 
Originally posted by group_theory
As a physician, when you refer someone to a chiropractor, you don't know what type of chiropractor your patient will see. Physicians will hesitate to refer their patients to chiropractors that they do not know (have no past dealings with).

From what I have heard, chiropractors outside the US (in Canada, UK, Australia, etc) are more standardized and less commercial in nature (no spinal screening in malls). They are also more uniform in nature so a physician won't have to worry about the type of chiropractor his/her patients will see.

Unfortunately, Australian chiros aren't much better. Maybe the Trade Practices Act limits their commercialism to a degree, but not much. Aussie chiropractors are well-connected to the American commercially-oriented, fundamentalist preacher-style chiropractic culture.

When I refer friends to an NMS specialist/manual therapist I go to great pains to help them understand what a chiropractor is likely to do (if that's their practitioner-of-choice), what's dinkum (sorry, Australian euphemism for 'honest and worthwhile') and what's not, what 'red flags' to watch out for (eg. up-front bulk payments) and what their rights as a patient are.

I usually refer in this order:
1. experienced osteopath or chiropractor whom I personally know and trust
2. female chiropractor (they tend to be sucked in by the rhetoric less)
3. manipulative physiotherapist (they tend to be too reductionist and too inexperienced in SMT for me to rank them higher)
4. Australian-trained male chiropractor (unless I know and trust them)
5. Palmer College (US) trained male chiropractor (super-fundamentalist school where a lot of older chiros practising in Australia trained before our schools were really up and running)

It's difficult to separate a skilled chiropractor from their rhetoric, since even those with the wall-to-wall BJ Palmer idolisation, quotes, anti-vaccination, scaremongering 'killer subluxation' literature can still prove to be excellent practitioners.

Australian chiros still do the spinal screening in malls thingumy, still scare patients silly with unnecessary x-rays and anti-vax stuff... but some are good at co-managing patients with doctors, physios, etc. An increasing number work alongside physicians.

And before we damn all chiropractors to hell for being bad doctors... I know more than a few medicos I wouldn't go to nor refer anyone else to in a fit of Sundays...

I walked into one bloke's clinic a few years ago with a recurrent gum infection and said I thought I might need Amoxyl (I was receiving root canal work and was out of town away from my dentist and in pain)... he didn't look at me (literally... didn't even look up, let alolne examine me) didn't take much of a history, and prescribed Amoxyl-forte!!! My dentist went nuts when she found out... and I walked away with the ****s for five days... and my dentist finally determined that the infection was being caused by structural damage at the base of the tooth-root... no amount of antib iotics would have dealt with the problem.

Medicos still over-use antibiotics at great risk to the public good... not to mention the individual's health sometimes.

Whatever your modality, good medicine comes from a mix of intellectual understanding, common-sense, compassion, empathy and experience
 
Originally posted by BMW19
You are all very ignorant about what chiropractic is or is not. Comparing us to snake salesman and astrologers is foolhardy and childish. I don't know exactly where all of the resentment from DO's comes from, but most of us DC's are sound, intelligent, rational gateway providers that would gladly refer to you guys if you would stop bashing us! It is prob. the fact that you think we "stole" manipulation from you guys which has no truth to it.
As far as you having a problem with us "being primary care providers" it is double-edged sword. If we don't diagnose and just manipulate we get bashed for being quacks who weren't aware of probs a patient had that might contraindicate manipulation. If we do dx, we are considered wanna be DO/MD's we can't win. Just so you know, most MDs have more respect for DC's than you do. I have one working in my office. Any questions or comments feel free to pm me. Until then keep on bashing out of ignorance!!!

BMW, DC

BMW (great tag btw mate)

Unfortunately, too many chiros do behave like astrologers and snake oil salesmen. That's the truth. It happens.

Unfortunately, people who aren't too familiar with the contemporary chiropractic profession (and some who are) dish out some rather ignorant anti-chiropractic rhetoric of their own. That's the truth. It happens.

Chiropractic has a terrible reputation, well earnt by some, of reacting very badly to criticism. In this way it (still) behaves more like a cult than a scientifically-based health care profession. Do medicos behave this way sometimes? Sure. But it doesn't excuse the behaviour from anyone.

If your profession were to ditch the 'Waiting List Practice' types and denounce the broad-brush claims of 'killer subluxations' it would a courageous show of leadership that would go a long way to earn the public's and the medical community's respect.

Chiropractic is often times its own worst enemy.

On the other paw, our osteopathic brethren in US could do a lot worse than taking the time to break bread with their chiropractic cousins.
 
Originally posted by group_theory
The problem with chiropractors in the United States is variability.

Some are great chiropractors, NMS specialists who know the limits of their practices and will refer patients to medical doctors for conditions out of their area of expertise.

Then there are some who will try to keep the patients coming back (weekly spinal health screening), do not know the limits of their knowledge, and pretend to be primary care physicians. Some may even try to convince the patients that the medical establishment is out to get them and that medicine is EVIL (and vaccination is evil).

Examples of both types were posted in this thread.

As a physician, when you refer someone to a chiropractor, you don't know what type of chiropractor your patient will see. Physicians will hesitate to refer their patients to chiropractors that they do not know (have no past dealings with).

I am a chiropractor myself and absolutely agree with what group_theory said above. And the problem is when DC's say "primary care" what they actually mean is direct access care. That is, patients can see them without a referral from a MD/DO and DCs can refer if something is outside their expertise or if they need consultation. Of course, in medicine, "primary care" means that there is also comprehensive care in general medical issues. Unfortunately, some DC's still think they can provide this service. Best advice for future physicians is to make sure you know what kind of chiropractor you send your patients to. Or, if your patients insist on seeing a chiropractor you don't know, just try to educate them on what kinds of chiropractors are out there.
 
Chiros not only practice primary care medicine. They can be specialists too.

Ever see a "chiropractic pediatrician" or a "chiropractic neurologist?"

These guys exist and they're just as phony.
 
Originally posted by moo
Chiros not only practice primary care medicine. They can be specialists too.

Ever see a "chiropractic pediatrician" or a "chiropractic neurologist?"

These guys exist and they're just as phony.

Why are they phony? Is that just your opinion, or do you have any objective information regarding the matter?
 
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