Thoughts about Chiropractic

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Bad outcomes with OMM are not usually related to the practicioner at all.

Then who assumes the responsibility for the bad outcome? What is it related to? If you do not keep current, and do not use the techniques very often, whose fault is it if a patient is harmed?

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.

It all depends on what you have seen, I suppose. But HVLA techniques CAN injure people, particularly if you "force" the technique. At least that is what I have been taught. I have also known of someone injured by an overenthusiastic and out of practice DO.
Sadly, I no longer believe that someone knows what they are doing when it comes to OMT just because they happen to have the title of DO.
It is my opinion that those who are truly gifted with the ability to help people affect change and improve their health, and use OMT as one means to do so, are those who have the wisdom not to "shove" things with their egos, instead choose to listen to the "inherent wisdom of the body" that they are laying their hands on........
Just a thought
 
rbassdo,

Yes I have applied and have received two interviews so far to DO school

BMW-
 
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.

Moo old mate,

Yes there are problems with chiropractic, but your comment isn't very helpful and is pretty misleading.

I know some chiropractic paediatricians - graduates of RMIT University (here in Melbourne) - and they're not all froot-loops by a long shot.
 
I just want to add something to this discussion as a chiropractic student here in Australia.

I, along with my fellow students strongly and hold to heart the necessity of Co-management of patients.

Basically it comes down to "Your not so great, We're not so great".

Never in a thousand years would I ever imagine acting as a primary healthcare professional. We are taught the absolute importance of referring patients when necessary and co-management of patients with other modalities of healthcare.

I don?t use the word Subluxation - I hold it in same regards to cursing.

After all, the patient is the bottom line in this industry, and where one modality of treatment was unsuccessful, another may be, however you would never know unless you actually gave the patient the opportunity to try.

Not too long ago, during "Chiropractic Care Week" here in Australia, the number 1 breakfast news show asked people to send in their opinions regarding chiropractic. 90% of respondents expressed positive views of the treatment and profession.

Ultimately, evidence or not, public approval and satisfaction will dictate the success of the profession.
 
I suggest you all check out www.chiromed.org

This is what chiropractic should be heading towards. If you are an MD/DO and want to help your patients, you need to know a DC that fits into this realm. This realm is basically a science/evidence-based scope limited to NMS.

Until proven otherwise, DCs should not be treating anything but NMS.

The DCs that fit into the NACM (see above website) guidelines can work well together with RMTs and PTs as well as MD/DOs.

Perhaps it would do these DCs a great service to change their names from chiropractors to something else...perhaps manual orthopaedic therapists...or something like that. Let the old-school chiropractors keep their name and pretend to be primary care...and let them take the term "subluxation" with them too.
 
For the chiropractors who have posted in this forum and are applying to osteopathic medical school, what made you decide to do this? Were you not satisfied with chiropractic or did you want to be able to offer patients the most comprehensive treatment possible?
 
Originally posted by PublicHealth
For the chiropractors who have posted in this forum and are applying to osteopathic medical school, what made you decide to do this? Were you not satisfied with chiropractic or did you want to be able to offer patients the most comprehensive treatment possible?

Well, as you can see, I'm not exactly in osteopathic med school but I like this thread. So, I'll stick my head in once more. However, I have applied to DO schools. For me, I discovered that medicine was something I was much more interested in. At the same time, I felt that the practice of chiropractic was not satisfying at all for me. I went into chiropractic school thinking I would be a doctor but I felt more and more like I was a physical therapist. And I was pretty disenchanted with reimbursements, the way the profession was handling itself, and how there weren't really any good opportunities available for an evidence-based chiropractor. Nor did I want to open up my own practice. It wasn't about offering a more comprehensive service because I think I'll end up specializing anyways. But it was about having a proper education and training common to all physicians. There are other reasons but those are pretty much most of my big reasons for leaving chiropractic.
 
Originally posted by coreyw
Moo old mate,

Yes there are problems with chiropractic, but your comment isn't very helpful and is pretty misleading.

I know some chiropractic paediatricians - graduates of RMIT University (here in Melbourne) - and they're not all froot-loops by a long shot.

I don't think it's right that a chiropractor can take a couple weekend seminars by paying 1000 bucks and then getting the title "chiropractic neurologist." It's misleading to the public and it's dangerous.

Chiros in the US are very different from those in other countries. A lot (not all) claim to be "physicians" and this is where I draw the line between a "good" chiro and a "bad" one.
 
Originally posted by moo
I don't think it's right that a chiropractor can take a couple weekend seminars by paying 1000 bucks and then getting the title "chiropractic neurologist." It's misleading to the public and it's dangerous.

Chiros in the US are very different from those in other countries. A lot (not all) claim to be "physicians" and this is where I draw the line between a "good" chiro and a "bad" one.

Its not a few weekends and a few thousand dollars.

The course is run through RMIT university, and is a 2 year full time Masters Degree.
 
Being fairly new to this forum, and only recently reading some of the threads outside allopathic, i've noticed some trends. MD's bash DO's, DO's bash chiropractors, and a combination of the aforementioned bash nurses and PA's, while in reality, none of us could completely function without those who we are trying to put down. Now, is it me, or are there alot of insecurities floating around? It seems that everyone getting bashed just wants to establish their profession as being seperate, and providing a different service, while those doing the bashing want to establish the dominance of their profession over the others. All you're doing is perpetuaing the same stereotypes you're trying to get rid of. It doesn't matter how phony you think Chiropractors are, if a big chunk of the general public believes in it, you're going to have to deal with it, you can't just dismiss it as "snake oil", or a sham.
 
Originally posted by moo
I don't think it's right that a chiropractor can take a couple weekend seminars by paying 1000 bucks and then getting the title "chiropractic neurologist." It's misleading to the public and it's dangerous.

Chiros in the US are very different from those in other countries. A lot (not all) claim to be "physicians" and this is where I draw the line between a "good" chiro and a "bad" one.

sorry mate... you need to do your research better. qualifying as a chiropractic neurologist in your country or mine requires a lot more than a couple of weekends.
 
It doesn't matter how phony you think Chiropractors are, if a big chunk of the general public believes in it, you're going to have to deal with it, you can't just dismiss it as "snake oil", or a sham.

Great point. This is especially true today, as alternative treatments such as chiropractic, massage therapy, nutrition, yoga, and a range of others are gaining increased acceptance among patients and healthcare professionals alike.

Perhaps someone found a way to cash in on such treatments?

Perhaps people are sick of taking 15 pills per day?
 
Anyone know of websites containing information about chiropractic specialties? If so, could you please provide the links?
 
Originally posted by Buck Strong
Being fairly new to this forum, and only recently reading some of the threads outside allopathic, i've noticed some trends. MD's bash DO's, DO's bash chiropractors, and a combination of the aforementioned bash nurses and PA's, while in reality, none of us could completely function without those who we are trying to put down. Now, is it me, or are there alot of insecurities floating around? It seems that everyone getting bashed just wants to establish their profession as being seperate, and providing a different service, while those doing the bashing want to establish the dominance of their profession over the others. All you're doing is perpetuaing the same stereotypes you're trying to get rid of. It doesn't matter how phony you think Chiropractors are, if a big chunk of the general public believes in it, you're going to have to deal with it, you can't just dismiss it as "snake oil", or a sham.

i could completely function without chiropractors, and so will my patients.
 
Originally posted by uclacrewdude
i could completely function without chiropractors, and so will my patients.

So.. how is it that you will keep "your" patients from seeing chiropractors? Is this going to be a sort of Big Brother setup, where you monitor their activities via hidden cameras, or are you going to be so great and be able to fix all pain all the time that your adoring patients wouldn't dream of going to a chiropractor?
 
Originally posted by uclacrewdude
i could completely function without chiropractors, and so will my patients.

Sorry you're so above it all. Chiropractors should cower in your presence. Focus on passing the boards before talking about your practice.
 
Personally, my belief is that the role of the chiropractor is being somewhat pushed farther into the edge of health care...looking to find a nitch somewhere.

As more PT's offer manual medicine and push into the realm previously held by chiropractors...where does that leave the DCs except for nutritional advice regarding coral calcium and magnet therapy!! While I appreciate the healing properties of manual medicine, I fail to see the role of a DC when PT and DO (OMT) is readily available. THe comprehensive care by a DO with referral to PT for exercise therapy seems to cover bases rather well.

Where does the chiropractor fit in the modern health care model???
 
I'm not sure what role PTs play in manual medicine (meaning orthopaedic manipulation) in the US but in Canada they offer little if anything in the way of manual medicine. The DO profession is not established and regulated in Canada so DCs are the ones to go to for manual orthopaedic therapy.

There is a big difference between chiropractic in the US vs. Canada and Australia. PTs in Canada have long sought training in manual therapy but due to various reasons, many leave the adjusting and manipulating to the DCs, and DCs leave much of the PT-side of things to the PTs. Although there are still many debated issues, the role of DCs in mainstream healthcare delivery seems to be more clear in Canada. I fail to understand why it cannot be the same in the US.
 
Originally posted by Freeeedom!
Personally, my belief is that the role of the chiropractor is being somewhat pushed farther into the edge of health care...looking to find a nitch somewhere.

As more PT's offer manual medicine and push into the realm previously held by chiropractors...where does that leave the DCs except for nutritional advice regarding coral calcium and magnet therapy!! While I appreciate the healing properties of manual medicine, I fail to see the role of a DC when PT and DO (OMT) is readily available. THe comprehensive care by a DO with referral to PT for exercise therapy seems to cover bases rather well.

Where does the chiropractor fit in the modern health care model???

The distinction between chiros, osteos and physios in Australia is a little blurrier than it used to be, but I'd almost always prefer/refer to an osteo or chiro for manual therapy over a physio.

The plus with physios is that they get hospital access, the minus is that they don't do enough manual medicine either in training or (mostly) in practice, they tend to be more reductionist and less skilled (although this isn't a universal).

Australian manipulative physiotherapists can be good, especially in terms of preventative and exercise advice (as well as physiological therapeutics), but again I think they're not as skilled at either NMS diagnosis or manual medicine as the average chiro or osteo.

There are certainly downsides to chiros here (a tendency towards over-treatment, some poor bedside manners, some pseudoscience and real estate agent-like saleman tactics amongst them), but overall I'd feel safer with a chiro performing an upper cervical adjustment than a physio.

Having said all of that, I see an osteopath every month or so.
 
Chiropractic already has their niche and has for quite sometime. When people think of manipulation or "cracking", "popping" or whatever they want to call it, they think of a chiropractor and not a physical therapist or a DO. Maybe 50 years ago they also thought about an osteopath but not anymore. People associate "chiropractic" or "chiropractor" with spine or back pain as well.

Many states do not allow a physical therapist to perform any sort of manipulation. The laws would have to change and that takes time and $$$. Chiropractic is very strong politically and ALWAYS fights to protect their interests. Also, most states require a physician referral for physical therapy. Since most medical doctors think manipulation is voodoo or witchcraft they probably won't be prescribing it. This will lead their patients down the road to the DC.

Most DO's do not even practice OMT. The DO in my town sends me all his manual therapy cases. As far as PT and exercise therapy goes, well we do that as well, which eliminates sending the patient out to physical therapist. I think a DO or MD referring directly to a DC covers the bases rather well too. Also with our larger scope of practice we have the ability to send their patients out for lab work or imaging without having to keep sending the patient back to the MD to order additional testing. We also have a lot more training than a physical therapist. Many people think chiropractors and physical therapists are the same thing. This is not true. Some of our treatments may overlap but our training is completely different.

Many DC's nowadays are hiring a PT to work in their office. This is a great setup as the DC performs any necessary manipulations, screens the patient and prescribes PT as necessary.

As far as magnetic therapy goes, I would agree that we have some quack jobs doing that sort of thing. Where they learn these things is beyond me as they do not teach us about magnets or crystals or any other hocus pocus in chiropractic school.
 
Originally posted by BackTalk
Chiropractic already has their niche and has for quite sometime. When people think of manipulation or "cracking", "popping" or whatever they want to call it, they think of a chiropractor and not a physical therapist or a DO. Maybe 50 years ago they also thought about an osteopath but not anymore. People associate "chiropractic" or "chiropractor" with spine or back pain as well.

Many states do not allow a physical therapist to perform any sort of manipulation. The laws would have to change and that takes time and $$$. Chiropractic is very strong politically and ALWAYS fights to protect their interests. Also, most states require a physician referral for physical therapy. Since most medical doctors think manipulation is voodoo or witchcraft they probably won't be prescribing it. This will lead their patients down the road to the DC.

Most DO's do not even practice OMT. The DO in my town sends me all his manual therapy cases. As far as PT and exercise therapy goes, well we do that as well, which eliminates sending the patient out to physical therapist. I think a DO or MD referring directly to a DC covers the bases rather well too. Also with our larger scope of practice we have the ability to send their patients out for lab work or imaging without having to keep sending the patient back to the MD to order additional testing. We also have a lot more training than a physical therapist. Many people think chiropractors and physical therapists are the same thing. This is not true. Some of our treatments may overlap but our training is completely different.

Many DC's nowadays are hiring a PT to work in their office. This is a great setup as the DC performs any necessary manipulations, screens the patient and prescribes PT as necessary.

As far as magnetic therapy goes, I would agree that we have some quack jobs doing that sort of thing. Where they learn these things is beyond me as they do not teach us about magnets or crystals or any other hocus pocus in chiropractic school.

I will just add to the Magnetic therapy discussion... I have never seen a chiropractor either selling or promoting any form of magenetic therapy.

BackTalk, are you a qualified chiropractor in Victoria?

Secondaly, chiroprctic in Australia is not taught at private chiropractic colleges, it is taught as a university degree, 5 years full time, physiotherapy is 4 years full time, so we have a little more education aswell.
 
Johnny69, I'm not a qualified chiropractor in Victoria. I practice in the United States. Yes, things here in the states are different in comparison to other countries. For example, a DO (Osteopath) is considered the same as a MD here but not in other countries.
 
This diagram shows how chiropractic fits within the medical model with respect to diagnosis and management (Note: you'll have to scroll down and click on "Chiropractic Scope and Practice"):

http://www.chirocolleges.org/paradigm_scopet.html

A good description of chiropractic:

http://www.chiroweb.com/find/whatischiro.html

Chiropractic is a branch of the healing arts which is based upon the understanding that good health depends, in part, upon a normally functioning nervous system (especially the spine, and the nerves extending from the spine to all parts of the body). "Chiropractic" comes from the Greek word Chiropraktikos, meaning "effective treatment by hand." Chiropractic stresses the idea that the cause of many disease processes begins with the body's inability to adapt to its environment. It looks to address these diseases not by the use of drugs and chemicals, but by locating and adjusting a musculoskeletal area of the body which is functioning improperly.

The conditions which doctors of chiropractic address are as varied and as vast as the nervous system itself. All chiropractors use a standard procedure of examination to diagnose a patient's condition and arrive at a course of treatment. Doctors of chiropractic use the same time-honored methods of consultation, case history, physical examination, laboratory analysis and x-ray examination as any other doctor. In addition, they provide a careful chiropractic structural examination, paying particular attention to the spine.

The examination of the spine to evaluate structure and function is what makes chiropractic different from other health care procedures. Your spinal column is a series of movable bones which begin at the base of your skull and end in the center of your hips. Thirty-one pairs of spinal nerves extend down the spine from the brain and exit through a series of openings. The nerves leave the spine and form a complicated network which influences every living tissue in your body.

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.

Chiropractic also places an emphasis on nutritional and exercise programs, wellness and lifestyle modifications for promoting physical and mental health. While chiropractors make no use of drugs or surgery, Doctors of chiropractic do refer patients for medical care when those interventions are indicated. In fact, chiropractors, medical doctors, physical therapists and other health care professionals now work as partners in occupational health, sports medicine, and a wide variety of other rehabilitation practices.
 
my main problem with manipulation, whether OMT or chiro is its scientific efficacy. it is easy to get an effect out of a person just by touching them, let alone doing some sort of manipulation. I am curious to know how studies on manipulation are done. are questions administered to patients after the manipulation, are there nerve studies, blood flow studies, etc? it also seems unnatural to almost hyper-extend the neck and other body joints. i do not know if OMT and chiros do this, but that is popular opinion when the subject comes up.

also, medicine changes. if it is proven that OMT or chiro manipulation is not efficacious or medications surgery or some other treatment is safer and works better, i think it is o.k. to let go of some of the old thoughts of manipulation and its role with D.O.'s. that's how science and medicine work. dynamic and not static.

I dont think this changes the basic DO training and thought of the body being a self contained healing unit as well as the patient not being a collection of symptoms, but an organism interacting withing the micro and macro world.

i will be attending VCOM in the fall and look forward to studying medicine (whatever that my encompass). i hope to learn how to utilize both scientific research and knowledege with sound clinical judgement to treat a particular condition. To me this is osteopathic medicine.

just my 2cents. hope not to offend anyone (plus its late and i am sleepy so i am not sure this makes sense)
 
Good point, mswphysician.

Efficacy and effectiveness are two different concepts. What works in an idealized clinical trial setting (efficacy) may not work in the real world (effectiveness). There have been some studies that have rigorously evaluated the efficacy/effectiveness of osteopathic manipulation in treating a range of disorders. Chiropractic research is lacking, although the Journal of Manipulative and Physiological Therapeutics frequently reports results from studies examining various chiropractic interventions or treatment modalities. Here is a sample of articles on osteopathic manipulation (go to www.pubmed.com for more):

Arch Pediatr Adolesc Med. 2003 Sep;157(9):861-6.

The use of osteopathic manipulative treatment as adjuvant therapy in children with recurrent acute otitis media.

Mills MV, Henley CE, Barnes LL, Carreiro JE, Degenhardt BF.

Department of Pediatrics, Oklahoma State University Center for Health Sciences, Tulsa 74107, USA. [email protected]

OBJECTIVE: To study effects of osteopathic manipulative treatment as an adjuvant therapy to routine pediatric care in children with recurrent acute otitis media (AOM). STUDY DESIGN: Patients 6 months to 6 years old with 3 episodes of AOM in the previous 6 months, or 4 in the previous year, who were not already surgical candidates were placed randomly into 2 groups: one receiving routine pediatric care, the other receiving routine care plus osteopathic manipulative treatment. Both groups received an equal number of study encounters to monitor behavior and obtain tympanograms. Clinical status was monitored with review of pediatric records. The pediatrician was blinded to patient group and study outcomes, and the osteopathic physician was blinded to patient clinical course. MAIN OUTCOME MEASURES: We monitored frequency of episodes of AOM, antibiotic use, surgical interventions, various behaviors, and tympanometric and audiometric performance. RESULTS: A total of 57 patients, 25 intervention patients and 32 control patients, met criteria and completed the study. Adjusting for the baseline frequency before study entry, intervention patients had fewer episodes of AOM (mean group difference per month, -0.14 [95% confidence interval, -0.27 to 0.00]; P =.04), fewer surgical procedures (intervention patients, 1; control patients, 8; P =.03), and more mean surgery-free months (intervention patients, 6.00; control patients, 5.25; P =.01). Baseline and final tympanograms obtained by the audiologist showed an increased frequency of more normal tympanogram types in the intervention group, with an adjusted mean group difference of 0.55 (95% confidence interval, 0.08 to 1.02; P =.02). No adverse reactions were reported. CONCLUSIONS: The results of this study suggest a potential benefit of osteopathic manipulative treatment as adjuvant therapy in children with recurrent AOM; it may prevent or decrease surgical intervention or antibiotic overuse.

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Fam Pract. 2003 Dec;20(6):662-9.

Randomized osteopathic manipulation study (ROMANS): pragmatic trial for spinal pain in primary care.

Williams NH, Wilkinson C, Russell I, Edwards RT, Hibbs R, Linck P, Muntz R.

Department of General Practice, University of Wales College of Medicine, Institute of Medical and Social Care Research, University of Wales-Bangor, Bangor, Wales, UK. [email protected]

BACKGROUND: Spinal pain is common and frequently disabling. Management guidelines have encouraged referral from primary care for spinal manipulation. However, the evidence base for these recommendations is weak. More pragmatic trials and economic evaluations have been recommended. OBJECTIVES: Our aim was to assess the effectiveness and health care costs of a practice-based osteopathy clinic for subacute spinal pain. METHODS: A pragmatic randomized controlled trial was carried out in a primary care osteopathy clinic accepting referrals from 14 neighbouring practices in North West Wales. A total of 201 patients with neck or back pain of 2-12 weeks duration were allocated at random between usual GP care and an additional three sessions of osteopathic spinal manipulation. The primary outcome measure was the Extended Aberdeen Spine Pain Scale (EASPS). Secondary measures included SF-12, EuroQol and Short-form McGill Pain Questionnaire. Health care costs were estimated from the records of referring GPs. RESULTS: Outcomes improved more in the osteopathy group than the usual care group. At 2 months, this improvement was significantly greater in EASPS [95% confidence interval (CI) 0.7-9.8] and SF-12 mental score (95% CI 2.7-10.7). At 6 months, this difference was no longer significant for EASPS (95% CI -1.5 to 10.4), but remained significant for SF-12 mental score (95% CI 1.0-9.9). Mean health care costs attributed to spinal pain were significantly greater by 65 UK pounds in the osteopathy group (95% CI 32-155 UK pounds). Though osteopathy also cost 22 UK pounds more in mean total health care cost, this was not significant (95% CI - 159 to 142 UK pounds). CONCLUSION: A primary care osteopathy clinic improved short-term physical and longer term psychological outcomes, at little extra cost. Rigorous multicentre studies are now needed to assess the generalizability of this approach.

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Altern Ther Health Med. 2000 Sep;6(5):77-81.

The effectiveness of osteopathic manipulative treatment as complementary therapy following surgery: a prospective, match-controlled outcome study.

Jarski RW, Loniewski EG, Williams J, Bahu A, Shafinia S, Gibbs K, Muller M.

Complementary Medicine and Wellness Program, Oakland University, Rochester, Mich., USA. [email protected]

CONTEXT: Osteopathic manipulative treatment has been reported to relieve a variety of conditions, but no studies have examined the outcome effects of osteopathic manipulative treatment as a complementary modality for treating musculoskeletal problems during postoperative recovery. OBJECTIVE: To assess osteopathic manipulative treatment as a complementary therapy for patients undergoing elective knee or hip arthroplasty. DESIGN: Prospective, single-blinded, 2-group, match-controlled outcome study. SETTING: Osteopathic teaching hospital. PATIENTS: Of 166 eligible patients, 38 were assigned to a treatment group and matched with 38 control subjects. INTERVENTION: The treatment group received osteopathic manipulative treatment on postoperative days 2 through 5. MAIN OUTCOME MEASURES: Days to independent negotiation of stairs, distance ambulated, supplemental intramuscular analgesic use, length of hospital stay, and patients' perceptions of treatment. RESULTS: Compared to control subjects, the intervention group negotiated stairs 20% earlier (mean = 4.3 postoperative days, SD = 1.2; control subjects 5.4, SD = 1.6, P = .006) and ambulated 43% farther on the third postoperative day (mean = 24.3 m, SD = 18.3; controls = 13.9, SD = 14.4, P = .008). The intervention group also required less analgesia, had shorter hospital stays, and ambulated farther on postoperative days 1, 2, and 4. CONCLUSIONS: Patients receiving osteopathic manipulative treatment in the early postoperative period negotiated stairs earlier and ambulated greater distances than did control group patients.

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Perhaps people are sick of taking 15 pills per day?

This is exactly how osteopathy was started in the mid 1800s. I find it funny that many people, particularly MDs, bash "alternative" forms of medicine such as osteopathy or chiropracty. These systems of treatment came about as a result of the inadequacy of allopathic medicine in 1800s American.

Allopaths seem to quickly forget their past, when an MD would prescribe toxic drugs to his patients, such as calomel, and use certain treatment modalities such as "bloodletting" to cure patients. Allopaths also used to be trained under an apprenticeship program, long before osteopathy came around. Even during this time, however, the impericism of allopathy attacked other forms of treatment during its day, including osteopathy, homeopathy, hydropathy, and the various other systems at work. This tradition continues today because it threatens the establishment of allopathic medicine as "the only medicine".

In the past, people chose something else over allopathy because the system injured them, shunned them, or wasn't able to cure them. People DO get tired of being poked, prodded, and drugged. Allopathy also cannot explain everything through science alone. Just look at how little we know about psychiatric conditions.

Whether these alternative systems are more than just placebo we don't know and may never know. We DO know, however, that patients treated with these systems are HAPPY and seem to be relieved. Isn't that what medicine is about?
 
Originally posted by JKDMed
This is exactly how osteopathy was started in the mid 1800s. I find it funny that many people, particularly MDs, bash "alternative" forms of medicine such as osteopathy or chiropracty. These systems of treatment came about as a result of the inadequacy of allopathic medicine in 1800s American.

Allopaths seem to quickly forget their past, when an MD would prescribe toxic drugs to his patients, such as calomel, and use certain treatment modalities such as "bloodletting" to cure patients. Allopaths also used to be trained under an apprenticeship program, long before osteopathy came around. Even during this time, however, the impericism of allopathy attacked other forms of treatment during its day, including osteopathy, homeopathy, hydropathy, and the various other systems at work. This tradition continues today because it threatens the establishment of allopathic medicine as "the only medicine".

In the past, people chose something else over allopathy because the system injured them, shunned them, or wasn't able to cure them. People DO get tired of being poked, prodded, and drugged. Allopathy also cannot explain everything through science alone. Just look at how little we know about psychiatric conditions.

Whether these alternative systems are more than just placebo we don't know and may never know. We DO know, however, that patients treated with these systems are HAPPY and seem to be relieved. Isn't that what medicine is about?

Very nicely said indeed!

In Australia i know it is a fact that the satisfaction rates of patients of chiropractic are very high. People have had some marvolous results from both chiropractic and osteopathy. Wheter there is a scientific study or not is often of little relevance to the patient whom has been helped where other modalities of care have failed.

My younger brother suffered chronic constipation right from birth, he was medicated and did all the rounds of the allopathic medical profession, nothing helped. He first saw a chiropractor when he was 3.5 years old, and we have never looked back. Seriously, do you tihnk my mother cared that there is practically zero evidence to explain why after 3 weeks of treatment his condition improved a hundred times over?

I know this is anecdotal evidence, and in the eyes of the scientific community it has little weight, however to the people it matters the most (the patients) it holds a wealth of significance.

Sorry for the rant
 
the only problem existing as result of anecdotal evidence, is that this is NOT the ONLY example of this occuring.... when the body is treated with respect as a complex machine you cannot simply prescribe medicine and expect everything to be just fine... but then again I guess we could all just rely on the bodies intrinsic ability to heal itself and just treat the problem... sounds like how I want to be treated(VERY sarcastically said)...

God Bless

DrDad
 
Originally posted by Johnny69
In Australia i know it is a fact that the satisfaction rates of patients of chiropractic are very high. People have had some marvolous results from both chiropractic and osteopathy. Wheter there is a scientific study or not is often of little relevance to the patient whom has been helped where other modalities of care have failed.

I know a study that shows high public satisfaction with chiropractic care in Oz. Unfortunately, the work I've seen did not assess patients who didn't come back after visiting a chiro, hence the results are probably skewed.

Before I go any further, I should say that personally (I've not see any studies to back me up here) I'm thoroughly unsatisifed with the care the community receives from GPs and medical specialists. (Won't go into specifics just now.)

And I'm not into chiro-bashing for its own sake - I hope my earlier posts show this clearly. (I've seen chiros and osteos for sixteen years, and have received good and not-so-good treatment from both kinds of practitioners).

Buuut.... I've spoken to a hell of a lot of people about manual medicine over the years and I have to say chiropractic does not have a great reputation when it comes to patient-centred care. I have no sound data to back me up, but Australian chiropractors ought to be awake and open to the anecdotal stuff...

I've also had several friends on the 'inside.' - i.e. friends in the profession, so I don't speak from complete ignorance at all.

With that said, and because I love manual medicine and don't like seeing it's practitioners get a bad name, here are some of the reasons why chiros get a bad rap:

A lot of chiros tend to (consciously or not) use scare tactics to keep patients coming back (the old 'killer subluxations' routine - I've known patients to break down and cry as a result of this approach... although the chiro never sees it).

Many seem to scare people with x-rays - often prescribed unnecssarily - that show wonky spines, when in fact x-rays rarely give a good indication of underlying functional spinal pathology and the body can cope with a hell of a lot of wonkiness without a problem.

There is a tendency amongst some chiros (especially those of the 'biophysics' ilk) to unnecessarily re-X-ray their patients at unnecessary expense (either to them or the public purse) and health risk.

There are too many chiros out there whose main aim in life, it seems, is to get bums on seats in the waiting room... in fact, there is a whole sales philosophy devoted to it: 'Waiting List Practice' seminars are very popular with chiros, esp. younger ones. Many chiros seem to measure success in terms of how many hundreds(!) of patient-visits their clinic has seen in the last week. There are too many stories of chiropractors flitting in to see the patient and flitting out again - the rack 'em and crack 'em approach to health care. I've heard more than a few stories (in all states of Australia) of chiros not even bothering to give more than a cursory glance at the patient's face!!! A lot of chiros exhibit a lot of 'rush-rush,' leaving the patient feeling like they can't get a word in edge-wise and generally feeling very uncomfortable.

Too few chiros employ soft-tissue and physiotherapy to aid in treatment and rehabilitation, and too many use heavy-handed high-force manoeuvres when there are alternatives (although this is changing thankfully). That said, too many use the activator instrument almost exclusively (where's the 'chiro' in that?!).

Too many still scare the pants off parents with anti-vaccination propaganda... and speaking of propaganda, Tedd Koren's stuff (which permeates chiros' offices in Oz) is particularly noxious and misleading, but by no means the only line of nonsense (probably comparable only with some of the worst excesses of the pharmaceutical industry!).

Many chiros still make outrageous claims about what SMT will do, and do differential diagnosis and co-management very poorly (BTW I do believe that SMT can be used to treat/co-manage some systemic disorders, but many chiros cross the line of science and ethical conduct IMHO).

Too many chiros ignore the patient's own take on their symptoms... even saying that chiropractic doesn't treat symptoms, only causes - what rubbish! symptoms are important to the patient and they should bloody well be important to their chiropractor too!

There ARE good chiropractors out there - I've known 'em, been treated by 'em, referred to 'em, even slept with 'em!!!. But the profession is simply its own worst enemy. There is a culture of odious religiousity and cold commerce in chiropractic that seems to emulate the worst of 19th and 20th century allopathic medicine rather than doing health care differently and better.

Now, I've known some hopeless osteopaths, but I would much rather refer people to someone who is going to treat them with respect, treat them humanely, spend some time with them, listen to them, not claim to be more than they are and apply the full toolkit of manual medicine (including some simple massage) as necessary.

Oh, and whilst science isn't all it's cracked up to be (ha! bad pun), it is the great bull**** sifter... and until chiropractic students are taught to embrace the spirit of science and critical thinking (not to the exclusion of other ways of seeing I grant you), the profession will continue to dig itself deeper into the poo.

Back in my foxhole now...
 
Originally posted by coreyw
I know a study that shows high public satisfaction with chiropractic care in Oz. Unfortunately, the work I've seen did not assess patients who didn't come back after visiting a chiro, hence the results are probably skewed.

Before I go any further, I should say that personally (I've not see any studies to back me up here) I'm thoroughly unsatisifed with the care the community receives from GPs and medical specialists. (Won't go into specifics just now.)

And I'm not into chiro-bashing for its own sake - I hope my earlier posts show this clearly. (I've seen chiros and osteos for sixteen years, and have received good and not-so-good treatment from both kinds of practitioners).

Buuut.... I've spoken to a hell of a lot of people about manual medicine over the years and I have to say chiropractic does not have a great reputation when it comes to patient-centred care. I have no sound data to back me up, but Australian chiropractors ought to be awake and open to the anecdotal stuff...

I've also had several friends on the 'inside.' - i.e. friends in the profession, so I don't speak from complete ignorance at all.

With that said, and because I love manual medicine and don't like seeing it's practitioners get a bad name, here are some of the reasons why chiros get a bad rap:

A lot of chiros tend to (consciously or not) use scare tactics to keep patients coming back (the old 'killer subluxations' routine - I've known patients to break down and cry as a result of this approach... although the chiro never sees it).

Many seem to scare people with x-rays - often prescribed unnecssarily - that show wonky spines, when in fact x-rays rarely give a good indication of underlying functional spinal pathology and the body can cope with a hell of a lot of wonkiness without a problem.

There is a tendency amongst some chiros (especially those of the 'biophysics' ilk) to unnecessarily re-X-ray their patients at unnecessary expense (either to them or the public purse) and health risk.

There are too many chiros out there whose main aim in life, it seems, is to get bums on seats in the waiting room... in fact, there is a whole sales philosophy devoted to it: 'Waiting List Practice' seminars are very popular with chiros, esp. younger ones. Many chiros seem to measure success in terms of how many hundreds(!) of patient-visits their clinic has seen in the last week. There are too many stories of chiropractors flitting in to see the patient and flitting out again - the rack 'em and crack 'em approach to health care. I've heard more than a few stories (in all states of Australia) of chiros not even bothering to give more than a cursory glance at the patient's face!!! A lot of chiros exhibit a lot of 'rush-rush,' leaving the patient feeling like they can't get a word in edge-wise and generally feeling very uncomfortable.

Too few chiros employ soft-tissue and physiotherapy to aid in treatment and rehabilitation, and too many use heavy-handed high-force manoeuvres when there are alternatives (although this is changing thankfully). That said, too many use the activator instrument almost exclusively (where's the 'chiro' in that?!).

Too many still scare the pants off parents with anti-vaccination propaganda... and speaking of propaganda, Tedd Koren's stuff (which permeates chiros' offices in Oz) is particularly noxious and misleading, but by no means the only line of nonsense (probably comparable only with some of the worst excesses of the pharmaceutical industry!).

Many chiros still make outrageous claims about what SMT will do, and do differential diagnosis and co-management very poorly (BTW I do believe that SMT can be used to treat/co-manage some systemic disorders, but many chiros cross the line of science and ethical conduct IMHO).

Too many chiros ignore the patient's own take on their symptoms... even saying that chiropractic doesn't treat symptoms, only causes - what rubbish! symptoms are important to the patient and they should bloody well be important to their chiropractor too!

There ARE good chiropractors out there - I've known 'em, been treated by 'em, referred to 'em, even slept with 'em!!!. But the profession is simply its own worst enemy. There is a culture of odious religiousity and cold commerce in chiropractic that seems to emulate the worst of 19th and 20th century allopathic medicine rather than doing health care differently and better.

Now, I've known some hopeless osteopaths, but I would much rather refer people to someone who is going to treat them with respect, treat them humanely, spend some time with them, listen to them, not claim to be more than they are and apply the full toolkit of manual medicine (including some simple massage) as necessary.

Oh, and whilst science isn't all it's cracked up to be (ha! bad pun), it is the great bull**** sifter... and until chiropractic students are taught to embrace the spirit of science and critical thinking (not to the exclusion of other ways of seeing I grant you), the profession will continue to dig itself deeper into the poo.

Back in my foxhole now...

All very nicely said and all very valid, and i say this as a chiropractic student.
 
I totally agree and thats coming from a doctor of chiropractic.
 
Originally posted by Johnny69
All very nicely said and all very valid, and i say this as a chiropractic student.

Well then... er... now that we seem to have sorted that one out, let's all bugger off down the Corkman for a cleansing ale and spot of Irish reels.

Actually, whilst we're on the subject my dear chiro mates, what IS it - do you think - about chiropractic that seems to give rise to the kind of behaviour I allude to?

We should catch up for a beer some time Johnny69... you're at RMIT, yeh?
 
Originally posted by coreyw
Well then... er... now that we seem to have sorted that one out, let's all bugger off down the Corkman for a cleansing ale and spot of Irish reels.

Actually, whilst we're on the subject my dear chiro mates, what IS it - do you think - about chiropractic that seems to give rise to the kind of behaviour I allude to?

We should catch up for a beer some time Johnny69... you're at RMIT, yeh?

Nah, I study at Macquarie University in Sydney, our program is structured as a 3 year undergraduate degree followed by a 2 year masters Degree. Im not sure why it is set up like this because it just results in us having to pay much more money in our masters degree than in our undergrad degree.

Im not sure what leads to the behaviour, perhaps most of it is financially motivated, i guess. I dont think the state of chiropractic is the same as in the US.

Basically it is a problem for me to use the term subluxation, seriously, i have seen chiropractic do some marvoulous things for patients, however on the other hand i have to question things such as long term care as a preventative measure towards degeneration, since there is no evidence for this. Im pretty much in the middle, and thats most likely the reason why i will not complete chiropractic, but rather move into either medicine of dentistry.
 
Originally posted by Johnny69
Nah, I study at Macquarie University in Sydney, our program is structured as a 3 year undergraduate degree followed by a 2 year masters Degree. Im not sure why it is set up like this because it just results in us having to pay much more money in our masters degree than in our undergrad degree.

Im not sure what leads to the behaviour, perhaps most of it is financially motivated, i guess. I dont think the state of chiropractic is the same as in the US.

Basically it is a problem for me to use the term subluxation, seriously, i have seen chiropractic do some marvoulous things for patients, however on the other hand i have to question things such as long term care as a preventative measure towards degeneration, since there is no evidence for this. Im pretty much in the middle, and thats most likely the reason why i will not complete chiropractic, but rather move into either medicine of dentistry.

All chiro and osteo courses are now structured with the 3/2 year BSc/MSc.

Sad to hear you're giving up on manual medicine - sound slike you'd make a good chiropractor mate!

Gonna complete the BSc and then do grad Med? Don't you wish there was a school that offered yank-style osteopathic medicine? Be a hell of a lot cheaper than going over there, even if they do seem to have lost some of their distinctiveness!

There is a real need for longitudinal studies of the health impacts of long-term use of manipulative therapy... I"ve seen some bits and pieces, but certainly nothing to fully justify the lovely little five-phase subluxation degeneration models (with all the lights, bells and whistles) that you often see in chiro clinics.

I can't see the term 'subluxation' going the distance (except as a colloquialism)... the majority of the chiropractic profession will, sooner or later, have to come to terms with the need for a common language with the other health care professions.

it's not that I have so much of a problem with the idea that somatic dysfunction can have some profound systemic consequences (there are some pretty persuasive clinical studies and it makes sense intuitively)... just that I don't like it when people try to over-sell the idea... over-simplify it... and make promises they can't keep. The thing manual medicine is best at is treating pain syndromes - no doubt about it - and that in itself can make a hell of a difference to a life.

I'm much more at home with the osteopathic or a liberal chiropractic philosophy that manual therapies are mostly complementary to medical intervention (judicious or conservative use of drugs & surgery, emphasis on preventative medicine, etc.).

Someone, I can't recall who, once said that if you wake up one morning to find that you feel no pain whatsoever, you can be quite sure that you're dead.

And on that cheery note... I'm often in Sydney, so give me a bell on the PM thingo if you want to give me your details... I'll get my lawyers to speak to your lawyers and we'll do lunch.
 
Originally posted by coreyw
All chiro and osteo courses are now structured with the 3/2 year BSc/MSc.

Sad to hear you're giving up on manual medicine - sound slike you'd make a good chiropractor mate!

Gonna complete the BSc and then do grad Med? Don't you wish there was a school that offered yank-style osteopathic medicine? Be a hell of a lot cheaper than going over there, even if they do seem to have lost some of their distinctiveness!

There is a real need for longitudinal studies of the health impacts of long-term use of manipulative therapy... I"ve seen some bits and pieces, but certainly nothing to fully justify the lovely little five-phase subluxation degeneration models (with all the lights, bells and whistles) that you often see in chiro clinics.

I can't see the term 'subluxation' going the distance (except as a colloquialism)... the majority of the chiropractic profession will, sooner or later, have to come to terms with the need for a common language with the other health care professions.

it's not that I have so much of a problem with the idea that somatic dysfunction can have some profound systemic consequences (there are some pretty persuasive clinical studies and it makes sense intuitively)... just that I don't like it when people try to over-sell the idea... over-simplify it... and make promises they can't keep. The thing manual medicine is best at is treating pain syndromes - no doubt about it - and that in itself can make a hell of a difference to a life.

I'm much more at home with the osteopathic or a liberal chiropractic philosophy that manual therapies are mostly complementary to medical intervention (judicious or conservative use of drugs & surgery, emphasis on preventative medicine, etc.).

Someone, I can't recall who, once said that if you wake up one morning to find that you feel no pain whatsoever, you can be quite sure that you're dead.

And on that cheery note... I'm often in Sydney, so give me a bell on the PM thingo if you want to give me your details... I'll get my lawyers to speak to your lawyers and we'll do lunch.

I will hold you to the lunch, and since i am a poor Uni student, you will pick up the bill, no??

As far as my future is concerned, i am not sure what it holds for me, i may finish chiro and love practicing as a chiropractor and stay with it, or i may change to med or dentistry or practice chiro for a few years and then go back to Uni??? Who knows, i am only young.

As a potential future chiropractor, i would be highly likely to practice purely on a musculoskeletal paradigm. There will be no subluxation posters in my office or any of those flashy toys.

I will have to say the only conclusion i can come to is that i am very much complexed on the issue. I am worried that if i was to practice purely on pain and function management, i would not be able to survive.

What exactly is it that you do in your occupation correy?
 
Originally posted by Johnny69
I will hold you to the lunch, and since i am a poor Uni student, you will pick up the bill, no??

As far as my future is concerned, i am not sure what it holds for me, i may finish chiro and love practicing as a chiropractor and stay with it, or i may change to med or dentistry or practice chiro for a few years and then go back to Uni??? Who knows, i am only young.

As a potential future chiropractor, i would be highly likely to practice purely on a musculoskeletal paradigm. There will be no subluxation posters in my office or any of those flashy toys.

I will have to say the only conclusion i can come to is that i am very much complexed on the issue. I am worried that if i was to practice purely on pain and function management, i would not be able to survive.

What exactly is it that you do in your occupation correy?

Professional environmentalist and possum-stirrer cum journalist of manual medicine cum wannabe osteopath... got a BSc in Biology at Murdoch for what it's worth and trying to write a popular science book on manual therapies in my spare time - ha! and pondering osteopathy and RMIT... or KCOM if my rich old Great Aunt Edna does the decent thing and karks before too long... but I'm getting old 🙁

Oh, and I make a fine cuppa and pour a great pint of coopers pale ale. So, yeh, I'll shout you.

Mate, there are hell of lot people out there with back, neck and head pain of mechanical origin... not to mention a myriad other NMS-related disorders! Methinks you'll survive.

And how about teaming up with a medico - do a duet on stuff like asthma and otitis media and whatever? Not that I'm reducing people to their diseases of course 🙂 Or specialise in MS rehabilitation?

Speaking of which, any of you DO students know a DO who works with a DC?
 
What are you people talking about???
I would imagine if you gave each other your personal emails, then you could keep this penpal relationship of yours.
Or perhaps you could try www.chiroweb.com

I would imagine that there are more productive places for chiropractors to swap recipes than on a medical student website!
 
Originally posted by Freeeedom!
What are you people talking about???
I would imagine if you gave each other your personal emails, then you could keep this penpal relationship of yours.
Or perhaps you could try www.chiroweb.com

I would imagine that there are more productive places for chiropractors to swap recipes than on a medical student website!

Surely you realise your inappropriate comments would be met with Callus.

There are so many threads on these forums, that it would be kind of you to skip over the ones you are not interested in and keep your $0.02 to yourself. It is not your job to police these forums and deem what is appropriate and not.

Secondaly, have you been to Chiroweb.com?

There are a lot of MDs, and DOs over there, so i dont see the odd company of a chiropractor or two here to be of any issue.
 
Originally posted by Freeeedom!
What are you people talking about???
I would imagine if you gave each other your personal emails, then you could keep this penpal relationship of yours.
Or perhaps you could try www.chiroweb.com

I would imagine that there are more productive places for chiropractors to swap recipes than on a medical student website!

Sheesh! You're so unhip it's a wonder your bum doesn't fall off!!!

Sorry I didn't respond to this earlier - got hit by a car on my bike last week and I've been recuperating since!

And sorry, but your comments just strike me as a truly sad and arrogant.

For the record, I'm not a chiropractor.

Further, the topic at hand is 'Thoughts on Chiropractic' and it's proven extremely popular.

If you don't like the topic, don't read it. Simple as that sunshine.

And if I were an student osteopath debating the merits of the modern chiropractic profession I would want to hear it from the horse's mouth.

And pardon us if we engaged in light-hearted banter!

If there were a debate on doctor-nurse relations, would you exclude nurses!?! Geez Louise.

What you have here folks is a fun, open and engaging website that allows others around the globe discover American osteopathic medicine in a unique and interesting way... I hope it stays that way.

I shall say no more on this petty subject, as it's making my whiplash injury flare up. (ouch!)
 
I don't know enough about chiropracty to make an educated opinion. I don't know if there is huge distinction between OMT and chiropracty. And I will admit what many of my classmates are afraid to on here and that I'm not crazy about OMT and I doubt I will ever use it. In fact, I think it's a nuisance.

There I said it.
 
Originally posted by azcomdiddy
I don't know enough about chiropracty to make an educated opinion. I don't know if there is huge distinction between OMT and chiropracty. And I will admit what many of my classmates are afraid to on here and that I'm not crazy about OMT and I doubt I will ever use it. In fact, I think it's a nuisance.

There I said it.

Not being picky, but the word you are looking for is chiropractic, not chiropracty.

Cheers
 
Anyone care to comment about the quality of education at chiropractic colleges in the United States? I have heard that Palmer is one of the best. Any thoughts about New York College of Chiropractic or University of Bridgeport College of Chiropractic?
 
Top school is probably Canadian Memorial Chiropractic College. The best in the states I would say Northwestern in Minnesota, Los Angeles College of Chiropractic (LACC), National in Chicago is very good as well. Logan, NYCC and TCC are all good schools and probably pretty close with minor differences. I actually went to Logan and am proud of the education I received. Palmer isn't that great, they like to think they're the best as it all started at Palmer. It's not enough anymore. The other schools are more scientific based and research oriented. Palmer in my opinion is in the middle. Half science based and half quackery. Life and Sherman are all quackery. I do not know much about the Bridgeport college.
 
Hey why don't you guys try www.chiroweb.com if you wish to discuss the inane practice of subluxation and spinal manipulation for all disorders (o/w called chiropractic).
Perhaps www.rehabedge.com will also provide an outlet.

Have a nice day.:laugh:

Captain Freedom
tellin it like it is
 
Originally posted by Freeeedom!
Hey why don't you guys try www.chiroweb.com if you wish to discuss the inane practice of subluxation and spinal manipulation for all disorders (o/w called chiropractic).
Perhaps www.rehabedge.com will also provide an outlet.

Have a nice day.:laugh:

Captain Freedom
tellin it like it is

I will direct you to my previous comments:

Surely you realise your inappropriate comments would be met with Callus.

There are so many threads on these forums, that it would be kind of you to skip over the ones you are not interested in and keep your $0.02 to yourself. It is not your job to police these forums and deem what is appropriate and not.

Secondaly, have you been to Chiroweb.com?

There are a lot of MDs, and DOs over there, so i dont see the odd company of a chiropractor or two here to be of any issue
 
best thing to do is ignore Captain Freedom ... s/he's obviously not interested in the discussion, is clearly not reading anything except the word 'chiropractic' which seems to trigger a primed response ...sort of like Pavlov's Dog

just goes to show that fundamentalist chiropractors don't have a monopoly on narrow-mindedness.

quite sad really.
 
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