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Should you be watching Arkansas?
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Should you be watching Arkansas? - July 26, 2005 4:24:00 PM
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brenna
Posts: 13
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From: arkansas
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I am sure that you all know by now that the Arkansas Supreme court agreed with the Arkansas State Board of Chiropractic Examiners that a "Pop", yes a noise, defines what is a Chiropractic manipulation in the State of Arkansas. So, if a Physical Therapist, or a Massage Therapist, or anyone else as far as that goes treats a patient and a "Pop" is heard then he/she has practiced Chiropractic and if not licensed to practice Chiropratic in Arkansas may be prosecuted. The punishment may just be $10,000 fine or it may be an injuction to make you stop practicing your healing art.
Anyway, now the Arkansas Supreme Court is about to decide if a Chiropractor can testify as to the standard of care required of a Physical Therapist. The fun part is that the definitions of the practice of Chiropractic and of Physical Therapy are being taken from the Webster's online dictionary. The practice of Physical Therapy is compared to the practice of Chiropractic as a paralegal is to a lawyer.
If the Arkansas Supreme Court agrees with the Chiropractors again, which I am sure they will, Chiropractors will be able to testify in Circuit Court against the Physical Therapists that they accuse of practicing Chiropractic due to the "Pop" definition.
I guess Physical Therapist in Arkansas will have a new governing board at that point.
If you are interested in seeing the Reply brief email me and I will email it to you.
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Re: Should you be watching Arkansas? - July 26, 2005 4:48:00 PM
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jma
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Hmm, if a DO gets a pop, will they go after them as well?
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Re: Should you be watching Arkansas? - July 27, 2005 2:43:00 AM
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JLS_PT_OCS
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jma, of course not. MDs and DOs have the money and they still have an iron grip on the healthcare system. They still vigorously oppose the expansion of privliges for other providers, regardless of type, with no real evidence for harm.
I think most DC organizations are way too smart to try to take on the physician lobby. They are too rich.
It's too bad not enough Osteopaths in the US still practice much manual treatment, or this sort of thing might not have happened in the first place.
J
_____________________________
Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: Should you be watching Arkansas? - July 27, 2005 4:06:00 AM
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KIDPT23
Posts: 222
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From: Illinois
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That is absolute bull @#@#! This whole health care system is becoming more and more ridiculous. Isn't it bad enough that we have insurance companies dictating patients' care. For example... Some people who have no experience in treating patients say that 6 sessions are enough for a certain diagnosis or post-op care. We have attorneys who are frickin lawsuit happy driving malpractice insurance through the roof. Now this... I can create a 'pop' on myself as can many people. There are times when i am performing passive cervical stretching and 'pops' are felt and heard. I think I am going to continue being a P.T. but be known as a personal trainer so i can do what i need to do when i want and be paid in cash without having to wait months to receive 30% of what i charge. Unfortunately I personally know some great physicians and physical therapists who have left the field to pursue other careers because of all the crap that we deal with. We should be able to just focus on what's most important...treating the patient.
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Re: Should you be watching Arkansas? - July 27, 2005 4:25:00 AM
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Jon Newman
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I'm not familiar enough with the legal aspects of what you are stating but it makes me wonder if a client of a chiropractor can get their money back if the chiro is unable to produce the "pop" because a chiropractic manipulation would not have been performed. In fact, I wonder if they would be able to be sued for performing a PT manipulation?
jon
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[URL=http://www.sonymusic.com/clips/selection/30/064887/064887_03_03_30.wav]Evidence[/URL]
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Re: Should you be watching Arkansas? - July 27, 2005 4:29:00 AM
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JLS_PT_OCS
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KidPT- Agree with your concerns. A cash based practice solves all those problems.
Jon-
I didn't think to turn it around, what a great idea...
J
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Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: Should you be watching Arkansas? - July 27, 2005 6:23:00 AM
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brenna
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From: arkansas
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Jon, That is pretty funny. The judges seem to be Chiro friendly here in Arkansas, so somehow that would backfire and we would end up with another fine. :)
A cash based pratice would not solve the problem. The private investigator that the Chiro Board sent to our clinic to pose as a patient paid us with cash.
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Re: Should you be watching Arkansas? - July 27, 2005 7:15:00 AM
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UTDC
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I was speaking to a PT about this the other day...Is it true that the PT's in Arkansas "gave away" manipulation as part of their practice act?
Jeff
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Re: Should you be watching Arkansas? - July 27, 2005 7:15:00 AM
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karmzack
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From: Hawaii
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Physical Therapy - The treatment of physical dysfunction or injury by the use of therapeutic exercise and the application of modalities, intended to restore or facilitate normal function or development. Also called physiotherapy.
Chiropractic - A system of therapy in which disease is considered the result of abnormal function of the nervous system. The method of treatment usually involves manipulation of the spinal column and other body structures.
Physical therapy certainly has a broader scope based on the definitions. I think the "Dr" title gets chiros more respect, now we are trying to catch up. I know there was a whole thread on this topic.
Doctor- 1. A person, especially a physician, dentist, or veterinarian, trained in the healing arts and licensed to practice.
2. a) A person who has earned the highest academic degree awarded by a college or university in a specified discipline. b) A person awarded an honorary degree by a college or university.
3. Roman Catholic Church. An eminent theologian.
4. A practitioner of folk medicine or folk magic.
5. A rig or device contrived for remedying an emergency situation or for doing a special task.
6. Any of several brightly colored artificial flies used in fly fishing.
Orthopedist - see 1.
Physical Therapist - see 2a.
Chiropractor - see 4.
_____________________________
Zack Solomon MPT, OCS, CSCS
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Re: Should you be watching Arkansas? - July 27, 2005 7:20:00 AM
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JLS_PT_OCS
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While a cash-based practice does not solve the "manipulation" issue, it does address Kid's concerns with the healthcare system, that's what I was addressing.
Good luck to you guys in Arkansas, if everyone there was both an APTA and AAOMPT member, then that would be a force to be reckoned with.
Has anyone explored the idea that these "pops" occur with therapy not directed at the spine?
Appeals actions?
J
_____________________________
Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: Should you be watching Arkansas? - July 27, 2005 7:26:00 AM
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JLS_PT_OCS
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Zack-
Our posts crossed, love those definitions!
Where are they from?
J
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Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: Should you be watching Arkansas? - July 27, 2005 8:57:00 AM
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karmzack
Posts: 181
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From: Hawaii
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[URL=http://dictionary.reference.com/]Dictionary.com[/URL]
I have to go there a lot to figure out what 'big' words mean, derr...
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Zack Solomon MPT, OCS, CSCS
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Re: Should you be watching Arkansas? - July 27, 2005 9:11:00 AM
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gmaven
Posts: 12
Joined: January 28, 2004
From: Edison, NJ, USA
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Hello:
It is very interesting to visit this board, as a DC, to read the perception of DC's by PT's, Zack's comment notwithstanding.
Who has the political ability to get certain provisions of practice law really depends on the state. I am sure there are states where all of the judges seem to rule in favor of the PT's and where the PT board sends patients into DC's offices(I know, the state I used to work in was famous for that). To be honest, this really is a big waste of time for both of our professions. There is no reason why both professions cannot co-exist to the betterment of the patients we treat.
The answer to the question is no, if you take a patient through passive ROM and there is a "pop" you should not be hauled before the state board.
I do not know about Arkansas and what their practice act entails, but I would ask if you (PT's) would report a DC who was performing treatment that was due to the practice act, outside of their scope?
Thanks for allowing a DC to participate in this forum,
g
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Re: Should you be watching Arkansas? - July 27, 2005 9:26:00 AM
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Randy Dixon
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In the case in question the therapist performed a spinal manipulation, it was obvious that was his intent, I don't think he ever denied that it was. The "pop" was incidental since the definition of manipulation was "taking a joint beyond the normal physiological ROM" This was, at the time, specifically prohibited in the Arkansas PT Practice act. He practiced outside the scope of his practice. It was pretty clearcut.
The question should be "Why did the PT's of the state allow the Practice Act to prohibit this?".
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Re: Should you be watching Arkansas? - July 27, 2005 10:19:00 AM
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karmzack
Posts: 181
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From: Hawaii
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gmaven - I guess my post was a bad joke, I should be more sensitive. I don't think linking chiro to folk medicine is necessarily bad, many alternative therapies fall into this category and manipulation is still common in folk medicine.
Randy, We take joints beyond the normal physiologic motion all the time. If we bend our finger back with our other hand, isn't that beyond normal physiologic motion moving toward end range anatomic motion. How about when we perform varus/valgus stress tests on the knee, if we find 'gapping' isn't that beyond normal physiologic motion?
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Zack Solomon MPT, OCS, CSCS
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Re: Should you be watching Arkansas? - July 27, 2005 10:33:00 AM
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curio
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Why is neither here nor there. Question should be where do we go from here. And what can we do? What can I do? If all 140,000 PT's actually followed the legislative issues concerning our profession and cared..would this ever happened? PT has been apathetic too long and may pay the price for it...
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Re: Should you be watching Arkansas? - July 27, 2005 1:24:00 PM
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jma
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From: NY
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I guess we'll have to see if this falls through and the next person gets brought to caught for the same reason as the previous one. Personally, I hope it doesn't.
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Re: Should you be watching Arkansas? - July 27, 2005 6:05:00 PM
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brenna
Posts: 13
Joined: July 5, 2005
From: arkansas
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Randy you are so wrong. If you would read the transcript of the chiropractic hearing Teston, the PT was not practicing outside of the scope of Physical Therapy. The PT Board reviewed the case and created a declaratory order that said that Teston was practicing PT. He never even did above a grade 3 mobilization on the patient. Which is clearly within the scope of his practice. The Arkansas PT practice act allows all mobilization. The exclusion that was added as a trade off for direct access says that PT's can not do spinal manipulations, which is a Chiropractic term and is defined in their practice act. Mobilizations as defined by the PT practice act are allowed on any part of the body.
It all really doesn't matter anyway. The definitions that should matter are in the practice acts. These definitions were not used. The laws and definition were not even addressed in the Chiro hearing. The term manipulation was defined in the hearing by chiropractors. They defined law that day and got away with it.
I don't understand why this does not make more PTs stand up and shout. If it can happen in Arkansas other states will follow.
[URL=http://www.defendphysicaltherapy.com]www.defendphysicaltherapy.com[/URL]
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Re: Should you be watching Arkansas? - July 27, 2005 6:09:00 PM
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brenna
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From: arkansas
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BTW, Randy how exactly do you determine when you have gone past the normal ROM? What is the definition of paraphysialogical range of motion anyway? I can't find a definition for that anywhere, but it sure is used a lot.
Trust me he denies that he performed a spinal manipulation as defined by the Arkansas Chiropractic Practice Act.
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Re: Should you be watching Arkansas? - July 27, 2005 9:20:00 PM
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goodlooks58
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gmaven: You asked if a PT will report a DC if the DC goes beyond their practise act...Let me ask you: Do DCs have any limitations of what they can do? prscribing meds, injections etc is not in a DC practise act, however, most DCs are selling supplements without any formal knowledge. If a DC has made a mistake in manipulation, they can order MRIs and most of them have working relationships with Neurosurgeons. My observation has been that DCs are much smarter when it comes to protecting their rear ends. The only news item you see occasionally about DCs is that soemone gets caugth in an insurance fraud scheme. How many times do you ever hear about strokes or paralysis caused by DC manipulations? Very rarely. This does not prove that DCs do not make mistakes, they are just smart in covering it. Again, this is my observation especially in my town.
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