I found this on chrioweb.com and I think it provides some insight into the mind of some of the DCs on the site.
"All you ever wanted to know about chiropractors . . .
By David Leprich
Anyone perusing the letters to the Medical Post will get a sense of the state of affairs between doctors and chiropractors. But if we set aside the emotion and become rational and objective, there are several facts that rise to the surface.
Many Canadians who visit chiropractors describe benefits, including reduced symptoms and increased function. Many doctors refer patients to chiropractors with confidence and satisfaction. Still, we see negative comments in the press about chiropractors, which perpetuate myths no more true than many of the myths people hold about the medical profession.
Chiropractors have not done a good job of telling doctors what we do. What follows are some of the more common questions raised about chiropractic and some of the facts surrounding these issues:
What kind of education and training do chiropractors receive?
Many doctors believe chiropractors are not well-trained. Chiropractors are educated as primary contact health-care providers with an emphasis on neurological and musculo-skeletal diagnosis and treatment. Preparation for the practice of chiropractic focuses on basic training in the biological and health sciences, specialized training in the discipline of chiropractic, and extensive clinical training. Becoming a chiropractor in Canada requires a minimum of six years of post-secondary education, including 4,500 hours of classroom and clinical instruction at an institution approved by the Council on Chiropractic Education, Canada.
Is chiropractic regulated?
Like medicine and dentistry, chiropractic is a self-regulating profession. In all provinces, licence requirements include a minimum of two years pre-professional university study and graduation from an accredited chiropractic college, which requires an additional four or five years of study.
What do chiropractors treat?
Chiropractors are experts trained in the diagnosis and treatment of the neurological and musculoskeletal systems. They treat disorders of the spine and its associated nervous system, as well as the peripheral joints by adjusting (manipulating) these articulations. Chiropractic treatment is a conservative means of managing a variety of disorders, including back and neck pain and headache. These conditions are representative of 90% of chiropractic treatment. The vast majority of chiropractors employ manual manipulation. They also employ treatment modalities (ultrasound) and soft tissue techniques and provide advice on exercise, nutrition and lifestyle modification. The emphasis is on involving the patient as a participant in their care.
Is chiropractic scientific?
What began as a poorly understood form of treatment more than 100 years ago has evolved into a healing discipline firmly grounded in science. Few other health-care interventions have been as extensively assessed as chiropractic manipulation. There have been at least six formal government inquiries into chiropractic worldwide. Each has concluded chiropractic care is safe and effective. Numerous clinical studies, including randomized controlled trials, attest to the appropriateness of chiropractic care or spinal manipulation, particularly for low back pain.
Is there a risk of stroke associated with neck manipulation?
In a word, yes. However, the risk is extremely remote, about the same as the risk from natural neck movements such as turning the head to back up while driving or tilting the neck back for hair washing. There are good studies which demonstrate the risk to be on the order of one occurrence per one million treatments. To put this in perspective, the risk of serious complication or even death (on a percentage basis) attributed to the use of NSAIDS for neck pain is far greater.
Why do chiropractors treat children?
The basic biological and physiological sciences which guide the treatment of adults apply equally to children. Chiropractic treatment is as beneficial for children as it is for adults, for the same conditions and for the same reasons. The scientific literature shows that low back pain is very prevalent among school children. A 1992 study published in the American Journal of Public Health found the prevalence of low back pain in children up to age 15 is more than 36%. This study concluded low back pain in adolescents is a serious public health problem.
Through periodic spinal examination, chiropractors can detect clues to possible postural problems which may predispose children to later neurological and musculoskeletal problems. Early detection and/or treatment, including referral, can minimize the potential impact of such conditions.
Do chiropractors refer patients to medical doctors?
As part of their training and education, chiropractors are able to recognize risk factors for treatment and disease patterns which require medical attention. Chiropractors do not hesitate to refer when it is in the patient's best interest. Unfortunately, all too often the medical practitioner is unwilling to accept such referrals.
Do medical doctors refer patients to chiropractors?
Absolutely. Recent studies show the majority of medical practitioners in Canada refer patients to chiropractors for the treatment of musculoskeletal conditions. For example, a 1995 study reported in Canadian Family Physician found almost 60% of Canadian medical doctors perceived chiropractic care as "useful" or "very useful" and more than 83% had referred patients to chiropractors.
Do chiropractors take a proper health history?
During the first visit, prior to any treatment, chiropractors are obliged to take a detailed health history. This includes details about lifestyle and risk factors to give the chiropractor a full picture of the patient's health.
Why do patients need to receive treatment so often?
Since chiropractic care is a hands-on treatment modality, the patient needs to physically be in the office for treatment. In contrast, a course of medical treatment may include the use of antibiotics daily for two weeks. Despite the oft-repeated myth that chiropractors "keep you going for the rest of your life," the average number of annual visits per patient is eight. Is every patient's treatment the same?
Chiropractors, like medical doctors, follow generally accepted protocols and guidelines. Treatment is specific to the condition diagnosed by the chiropractor. Spinal manipulation may well be performed on a majority of patients, but nature and location of the spinal adjustment will be directed to that patient's specific needs.
Why refer to a chiropractor when a physiotherapist can do the same job?
Chiropractors are recognized by legislation as primary contact professionals in all jurisdictions in Canada. Physiotherapists are not. Chiropractors are trained to perform differential diagnosis. Physiotherapists are not. Physiotherapists are not trained to take and interpret X-rays. Chiropractors are. Chiropractors are highly trained in the application and recognition of contraindications to spinal manipulation.
Can a medical doctor be sued for referring a patient to a chiropractor?
No more or less than a doctor can be sued for a referral of a patient to a hospital for an X-ray study. Each medical doctor and chiropractor is held to his/her standard of care and cannot be held liable for the actions of another provider that has his/her own standards.
Is there anything else I should know?
You are probably aware that many of your patients are already receiving chiropractic care. You can ignore this, or even attempt to discourage it, but they will still go. It would be far more productive for you, as a concerned physician, to talk to your patient about who they see. This will tell you a lot more about what benefits they are receiving, how the local chiropractor works and what sort of conditions are being treated. Better yet, if you have specific questions or concerns, why not take call the chiropractor? Most chiropractors would be happy to spend a few minutes telling you what they do. The information you garner can only be of benefit to your patients.
David Leprich is chairman of the board of governors of the Canadian Chiropractic Association. "
