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chiropractors working with PT's
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chiropractors working with PT's - May 18, 2007 10:16:00 AM
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Rehab101
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Hi everyone--
I have recently graduated from PT school and been offered to partner with a well known chiropractor in a fitness center. I know there are many PT's who work with and/or share office space with chiropractors and there is potential for both parties to make a good income. However, I also feel there is a lot of potential for being taken advantage of seeing that PT gets reimbursed more on avergage than does chiropractic care and that chiropractors are routinely audited and working with them, your liscense would also be on the line. Would anyone be able to share their experiences and discuss what is the safest way to go about partnering with a chiropractor and red-flags to look out for?
Thank you so much!
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Re: chiropractors working with PT's - May 18, 2007 2:44:00 PM
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3.5fig
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I am a Chiropractor who has worked with and for Physical Therapists. In fact I am in the process of setting up a new venture with a Physical Therapist. As long as the Chiropractor is ethical you shouldn't have any billing problems. The same could be said for the Physical Therapist as well. The main thing is to work out the business relationship before you go into it...have it all written down so everything is well understood. Also, you want to make sure that your treatment styles and approaches mesh well together. Have you met this Chiropractor yet? Make sure that your personalities mesh as well. Over the last 12 years I have learned that you better enjoy being around the person you are going into the business with because you are going to be spending all week and having to make daily decisions with this person. If the personalities clash, the business aspect of it will not be very enjoyable.
I wonder where you get the information that Chiropractors are routinely audited. I have been in practice 12 years and never been audited. My brother-in-law has been in practice over 25 years and has never been audited...in fact, I can't think of one classmate I keep in contact with who has been audited. What is the source for that statement? Are there some government statistics or something out there stating that? Just wondering...
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Re: chiropractors working with PT's - May 18, 2007 6:01:00 PM
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savela
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From: toronto
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I work with a chiro in a fitness club setting. Since we both treat the same injuries and use similar techniques, we are in competition with each other.
I find the challenge is.... when the pt. with a tendinopathy wants to book an apt. and is not sure what profession to book in with.
I have worked hard to establish a good practice which I am reluctant to leave. If I had to do it over again......I would stick to working with PT's.
If you are on a salary, it would be an ok situation if you respect each other.
If the Chiro owns the company, he/she will promote you for financial reasons and it should be fine.
If you use similar treatments (ie.ART, ATSM , exercise)and work pay per pt. I would not work in the same clinic. Our professional boundaries in out pt. ortho. have crossed. PT's manip....chiro's do "rehab".
I work in Canada, so I still have MD's referring to PT, so it helps.
If you speak with the Chiro, and he/she is all about the buzz word "ART", that is a red flag. It is a tool, like Mulligan, Mackenzie, ATSM , but some will market ART like it is the best treatment ever. It works for muscle, but not for everything.
Ask a lot of questions.
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Re: chiropractors working with PT's - May 20, 2007 9:42:00 AM
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wvupt03
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Quote: "If the Chiro owns the company, he/she will promote you for financial reasons and it should be fine."
In my opinion, that is not fine at all. I use to work for a chiro owned practice. I was promoted for all the wrong reasons. The main being his financial gain. (The biggest reason I left.) I would discharge a patient, and behind my back, he would tell them to get a new referral from their MD (medicare patients usually) to resume PT. From my experience, and this is my opinion only, with the ethical questions and financial relationship. I would argue against such a venture.
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Re: chiropractors working with PT's - May 20, 2007 11:07:00 AM
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savela
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From: toronto
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Adam,
I am sorry that happened to you, but I think you misunderstood my post.
The chiro I work with does not control who I treat,what or how I bill nor does he own the clinic.
I was talking about the "competition" between PT's and Chiro's working in an out pt. clinic. If we treat using the similar tech. it may be confusing to the pt.
I know some great Chiro's who promote PT and bill ethically.
I guess what I was trying to say to Rehab 101, is to ask questions and may sure you do not get into a "partnership" with an unethical person.
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Re: chiropractors working with PT's - May 23, 2007 4:03:00 AM
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TMondale
Posts: 131
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From: Newton-Wellelsley Hospital
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Rehab101,
You're a new grad so you probably don't know any better, but don't even consider it. There is nothing good for you to be gained by this relationship, and plenty of bad to come of it. Ask yourself what's in it for you; besides possibly a bigger income (maybe, maybe not)than many of your classmates. It doesn't even matter how "good a person" this chiro might be, we should not be associating on a professional level with chiros at all. We don't need them in the least, and that connection will only serve to besmirch our reputation as responsible providers of the highest standard of musculoskeletal care.
Tim
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Re: chiropractors working with PT's - May 23, 2007 4:41:00 AM
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jsalva
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Tim,
I think that comment may be a little harsh. While, I have never worked with or for a DC, I do have personal relationships with a few. They do a great job with their pt's and provide good service that gets results. They are aware of their practice limitations and will even refer to PT.
That is not to imply that all DC's follow in that line of thinking, but I have also worked with/for PT's with questionable ethics.
John
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Re: chiropractors working with PT's - May 23, 2007 5:29:00 AM
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TMondale
Posts: 131
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From: Newton-Wellelsley Hospital
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John,
Thanks for the response. It has nothing to do with personal relationships. One of my favorite people on earth is a chiro; hell of a good guy. I'm trying to say in the most unconfusing terms that we shouldn't be involved in a professional manner with them. We are the standard for excellence in neuromusculoskeletal care and we don't advance ourselves by that connection. To say that because their patients get better too that that justifies some link to us, doesn't work.
It's nothing personal
Tim
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Re: chiropractors working with PT's - May 23, 2007 7:35:00 AM
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jsalva
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Understood. I have been approached about working with a DC as a partnership, and had to decline. I do not think there should be a link between the professions either.
John
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Re: chiropractors working with PT's - May 23, 2007 2:44:00 PM
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3.5fig
Posts: 97
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Tim,
At the risk of being rude, and trust me I do not mean to be, but your posts seem very hypocritical to me. You first state that "we should not be associating on a professional level with chiropractors at all...and that connection would only besmirch our reputation as responsible providers of the highest standard of musculoskeletal care", clearly insinuating that chiropractors are not "responsible providers". You then go on to state that one of your "favorite people on earth is a chiro...hell of a great guy". Excuse me for seeing the hypocrisy here...on one hand you hold out this ethical standard in your professional life, yet do not hold the same standard in your private life. I for one would not want to associate with someone who I thought was an irresponsible provider of care.
A few questions...have you ever referred a patient to a chiropractor? would you ever refer a patient to a chiropractor? have you ever been to a chiropractor's office and watched him/her work with patients? have you had a personal or professional bad experience with a chiropractor before? what place do you think that a chiropractor plays in the health care profession in the United States?
I ask these questions to find out the reasoning behind your two posts above. I would like to understand your past experience and knowledge of chiropratic to better understand the reasoning behind your posts.
This is coming from a chiro that has spent the better of the past 12 years working with PTs and found that not only did it advance both of us in our treatment skills, but certainly advanced positive outcomes for our patients...which I think is the main goal to begin with...
Thanks
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Re: chiropractors working with PT's - May 24, 2007 1:57:00 AM
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SJBird55
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From: Michigan
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3.5fig... you really don't truly know that positive outcomes for patients were advanced. Have you done any studies to compare or to substantiate that statement? What data have you consistently collected that you use to substantiate that statement and what literature are you using when comparing your outcomes to published outcomes?
Personal relationships are different than professional relationships. One can like a chiropractor personally but be against chiropractic professionally. I don't believe that is hypocritical.
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Re: chiropractors working with PT's - May 24, 2007 2:28:00 AM
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Sebastian Asselbergs
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...and I have a lot of bad things to say about car salesmen, yet I know one I would trust my life to. The personal and professional are soo different.
A person is NOT defined by their professional colleagues. A profession is defined by the behaviour of many of its members and its public image, and peception of the other professions.
I can see Tim's distinction quite clearly!
Similarly, I can say that a chiro friend of mine is NOT thrilled with my profession, since she has had experience with the "assembly-line" PT clinic here....But she still thinks I OK.... (I know I know - poor judgement! LOL)
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Re: chiropractors working with PT's - May 24, 2007 6:28:00 AM
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3.5fig
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When I said advanced outcomes, I meant compared to what either of us, myself and the PT, were getting on our own. If you look at what I said, I said "our patients"...I was not making a statement as broad as to the whole population and if I inferred that then I apologize. I was just speaking of our own experience with our patient outcomes. We were much more effective together than when apart.
As to the personal and professional, I guess that we are just different. I carry the same ethical standard in both my personal and professional life. If I can't respect someone or his profession enough to interact with him/her professionally, then there is no way I could interact with him/her on a personal level without feeling like a hypocrite. Maybe that is just me. SJBird, you say "be against chiropractic professionally"...what does that actually mean? Please explain if you would....I don't know, but I sure would not want to be friends with someone who, while they like me personally, on the professional level they have not respect for me and consider what I do to be irresponsible. Let me pose a hypothetical question for you...You are at the North American Spine Society meeting and talking amongst a group of professionals (PT,MD,DO) and up comes your personal friend the DC, who you hold no professional respect for and would not professionally associate with because of your views regarding his profession and how he/she could besmirch your chosen profession. Explain to me how you would act in that situation...Would you say, "Oh, I would like you all to meet my personal friend, Dr. So and So who is a DC...by the way, I have just have to say that even though he is a personal friend of mine, I don't believe that he is a responsible healthcare provider and don't respect his profession." I would think that it would be very uncomfortable and possibly embarrassing for your personal friend who you hold no professional respect for..put yourself in the others shoe's. I sure would not want to be friends with someone who thought I was irresponsible and had no respect for my profession...I have a little more self-respect than that.
Each and every profession has its bad apples, but I do not disrespect a whole profession because of the bad apples....
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Re: chiropractors working with PT's - May 24, 2007 7:27:00 AM
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3.5fig
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ok...I just re-read my post and apologize for the grammatical errors...jeezh, Sister Barbara back in Catholic High School english class would rip me apart...
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Re: chiropractors working with PT's - May 24, 2007 8:19:00 AM
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proud
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Two points:
1. I see that chiropractors can provide evidence based care in an ethical manner. Several posters here have proven that to me. Unfortunately on a whole however, the chiropractic profession has a long long way to go( as Mark has indicated in the past, moreso in the U.S). So in my mind, it is possible to be friends with someone whom you percieve as acting ethically and in the best interest of patients, but not want to be associated with the particular profession on a whole. If you know what I mean.
2. Physiotherapy is not without it's troubles. There are many. However I see that PT is moving in the right direction at a much faster rate than chiropractic. For sure in the United States anyway. So as each profession strives to be "the" expert in NMSK management, I do not think PT's will require chiropractic at all.
Unless you subscribe to the notion that spinal manipulation requires years of training. That debate has been round and round here many times. I respect anyone who feels that way but suggest the research says otherwise and THAT research just keeps getting stronger and stronger( much respect to Mark and Buddy with whom I have discussed this previously).
Anyhow, I think it is important to say that each profession will have it's share of good and bad. I just think PT's are better positioned at the moment to benefit from a healthcare environment that will demand evidence based practice. And the research would indicate that there is no real need for collaborative practice settings involving the two as more and more PT's learn simple manipulation techniques and apply them to appropriate research based sub-groups.
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Re: chiropractors working with PT's - May 24, 2007 5:01:00 PM
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TMondale
Posts: 131
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From: Newton-Wellelsley Hospital
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3.5fig,
Your rudeness is no problem. In response to you thinking me hypocritical; let me straighten you out. I have no problem seperating the personal from the professional. I don't expect perfection out of those I admire, nor do they expect it from me. I do however easily label PT the profession of responsible musculoskeletal care based not on the notion that every one of our professionals are top rate, but rather because our professional organizations promote care based on the latest evidence, while yours bases your care on the most absurd theory of the dreaded subluxation. By the way fig please define subluxation for us; that would be enlightening. It doesn't matter whether you yourself believe in it, it's what your profession was born of and holds to.
Your profession thinks nothing of fraudulently using the good name of PT in your advertising as if your qualified to represent. You justify this professional dishonesty by the name of the courses you were taught in school.
And last but not least, instead of your professional governing bodies promoting involvement in developing research that advances musculoskeletal care, particularly from a manual perspective it would rather spend everyones time and money (unsuccessfully) trying to deny PTs practice acts from allowing thrust manipulation.
Yes fig I have no problem describing PTs as the responsible choice for neuromusculoskeletal care.
Tim
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Re: chiropractors working with PT's - May 25, 2007 6:34:00 AM
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3.5fig
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Whoa, guess I touched a nerve there. I was really trying to understand where you were coming from with you posts to John, which is why I asked those certain questions. You didn't care to answer any of the questions, but your tone and attack on the chiropractic profession gave me a good understanding of your thinking. We could go on and on about the pros and cons of chiropractic, both as a profession and as a political organization. However, that has been done to death so many times it is not worth it to take up the space on this wonderful forum. Maybe we can debate and discuss over a few beers sometime.
Just so you know, I never said that I expected perfection from anyone, but that I apply the same ethical standard in my private life that I do in my professional life...maybe that's just me, I don't know. I wonder if that Chiro you know who you consider "one of your favorite person on earth" and a "hell of a great guy" knows that what you think about his profession? I would have a hard time being a friend with someone who thought so poorly of my profession, as I believe if one choses to be in a fraudulent profession with very low ethical standards, that reflects on their personal character. An example for you would be a pornographer...I could never be friends or think someone is a great guy if that was the profession that he/she chose. Once again, maybe it is just me..I don't know...
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Re: chiropractors working with PT's - May 25, 2007 7:45:00 AM
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proud
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pornographer...chiropractor...???
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Re: chiropractors working with PT's - May 25, 2007 8:06:00 AM
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3.5fig
Posts: 97
Joined: July 13, 2005
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I know...bad example...I was just trying to think of a profession that I would and could not associate with someone on a personal basis and that was the first one that came to mind...did not mean to insinuate a connection between the two...although like Chandler on the TV show Friends, there are plenty of jokes floating about in my head right now that I don't think I should say on this public forum...haha...
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Re: chiropractors working with PT's - May 25, 2007 9:22:00 AM
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TLB
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From: Arizona
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3.5, I understand exactly where Tim is comming from when he implies it is about the profession not the professional. This is a distiction you fail to make and I believe you understand it, just don't want to admit it for whatever reason. Tim simply states why bring our physical therapy profession down to a level that was founded on little reseach and a wacky theory called subluxation, there is no upside for us so why even think about it. I don't know why you find this difficult to understand it isn't personal it's just the differnce between the two professions.
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Todd
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