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Re: WHY?
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Re: WHY? - January 13, 2006 6:33:00 AM
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husny
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I have been following these threads with wide interest and have reached conclusion that something definitely has to be done about this dear profession of ours.this i think is to support our associations and organizations,give them posssible co-operation and unite ourselves with one common goal that our leaders we will bind ourselves with.This professon is ours and it is left for us to protect and advance it.
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Re: WHY? - January 13, 2006 9:55:00 AM
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shutterspeedfilms
Posts: 9
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Wow. Where did this thread come from?
For a moment, I thought I was on the chirotalk website. The same sentiments are expressed there on a daily basis (though twice as much as on this website). The DC's there feel their profession will become a relic within the next 20 years.
As someone looking to change careers myself, it's terrifying to see people talking about changing careers soon after graduating from PT school.
So which profession actually has it worse--chiropractic or physical therapy? Or is this a general health field-related phenomenon? I shunned chiropractic as a possible career choice because of so much negativity expressed on the chirotalk forum. Now it seems to be spilling over into PT, as well.
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Re: WHY? - January 13, 2006 11:50:00 AM
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Randy Dixon
Posts: 744
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Actually it is interesting to look at this time capsule. Notice the dates of the beginning posts. It was all gloom and doom then, and with some good reason. I don't know about you but I see a lot of advertisments for PT's now.
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Re: WHY? - January 15, 2006 3:52:00 PM
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shutterspeedfilms
Posts: 9
Joined: January 6, 2006
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My mistake.
I didn't take into account the dates on the posts. It all makes perfect sense now.
I'm guessing things have improved greatly since this post in 1999, seeing as how I haven't found any thread close to being that pessimistic around here lately.
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Re: WHY? - January 18, 2006 5:57:00 AM
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GLASGOW
Posts: 91
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Remember that chirotalk is a anti-chiropractic site and not an entirely balanced souce of information.Chiropractic in general seems to be fairing extremely well and considering the apparently high salaries these doctors get paid maybe there is a lesson to be learned from the chiropractors.
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Re: WHY? - January 18, 2006 7:07:00 AM
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JLS_PT_OCS
Posts: 1684
Joined: January 30, 2005
From: USA
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Glasgow-
Your post about the quack DC who is "well to do" and has "good patient retention" in the other thread makes perfect sense now that I have read what you just wrote.
We have discussed the salary issue as well as the failures of new practices and overall lack of growth and nearly nonexistent research agenda in chiropractic before.
Chirotalk doesn't claim to be unbiased as far as I know, but that doesn't make the research and salary citations there wrong, now does it? :)
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: WHY? - January 18, 2006 9:50:00 AM
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shutterspeedfilms
Posts: 9
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Busted. Heh.
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Re: WHY? - January 19, 2006 4:56:00 AM
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GLASGOW
Posts: 91
Joined: July 30, 2005
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I can not realy comment on the site. But I would guess yes,very likely such information is skewed.
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Re: WHY? - January 23, 2006 1:06:00 PM
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jaymango42
Posts: 7
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Where is silvernail on this conversation??
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Re: WHY? - January 23, 2006 2:40:00 PM
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JLS_PT_OCS
Posts: 1684
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From: USA
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jay-
I'm two posts back. Thanks for asking.
I've nothing new to add.
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: WHY? - January 24, 2006 7:48:00 AM
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Jeep
Posts: 353
Joined: March 28, 2003
From: USA
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[QUOTE]"... overall lack of growth and nearly nonexistent research agenda in chiropractic before.
Chirotalk doesn't claim to be unbiased as far as I know, but that doesn't make the research and salary citations there wrong, now does it?" [/QUOTE]Jason-
I do not know how you define "unbiased" or wrong" , but your sources, leading to the above claims is, at best, inaccurate. I have posted the following few sources which are verifiable and document both chiropractic "growth" and "research" It is unfortunate that you have been led to believe otherwise.
A few research cites:
http://www.c3r.org/publications.htm
http://www.nuhs.edu/show.asp?durki=480&site=2&return=17
VA hospital developments:
As part of the Fiscal Year 2006 Department of Defense (DoD) authorization bill, Congress included language to require the U.S. Air Force to complete implementation of chiropractic services at 11 sites that had not yet opened in accordance with a 5-year-old Pentagon plan to make chiropractic care available to active duty members of the military.
Specifically, the bill calls on the Secretary of the Air Force to ensure that chiropractic healthcare services are available at 11 facilities previously slated to offer chiropractic care but that have not opened a clinic or made the benefit available on base.
If the Air Force determines it is unnecessary or unfeasible to provide chiropractic healthcare services at any identified facility, the Air Force will provide chiropractic services at an alternative site located off base. The Air Force is given until Sept. 30, 2006, to complete implementation at these 11 locations:
Bolling Air Force Base (AFB), Washington, D.C.;
MacDill AFB, Florida;
Hurlburt Field AFB, Florida;
Nellis AFB, Nevada;
Elmendorf AFB, Alaska;
Luke AFB, Arizona ;
Maxwell AFB, Alabama;
Randolph AFB, Texas;
Robins AFB, Georgia;
Kirtland AFB, New Mexico;
Pope AFB, North Carolina.
The Air Force language contained in the bill, if signed by the President, would increase the number of military bases with a chiropractor from 42 to 53.
To read the September 2005 GAO report on chiropractic in the military, visit: [URL=http://www.acatoday.com/pdf/GAO_DODchiro.pdf.]www.acatoday.com/pdf/GAO_DODchiro.pdf.[/URL]
To read ACA’s response to the September 2005 report, and for other ACA actions regarding expanding chiropractic care in the military, visit: [URL=http://www.acatoday.com/government/dod/.]www.acatoday.com/government/dod/.[/URL]
Chiropractors may treat inpatients in VA hospitals (see Recommendation 11 in this link): http://www1.va.gov/primary/docs/FinalReportofCAC.pdf
There is also interest in getting chiropractic research going in the VA system: http://www1.va.gov/resdev/funding/s...ractic_care.pdf
In addition to having full staff privileges in VA hospitals, DCs on the staffs of hospitals in the US is growing. eg:
http://www.henryfordhealth.org/body...detail&ref=3907
http://www.winchesterhospitalchiro.com/doctors.html
http://www.umassmemorial.org/ummhc/...ndpractices.cfm (scroll down under "Chiropractic")
http://www.fmchealth.org/doctors/ch..._services.shtml
http://www.advocatehealth.com/gshp/...ts.html#valeria
http://www.bethesda.med.navy.mil/pa...tics/index.aspx
http://tricare.osd.mil/chiropractic/factsheet.htm
http://www.cayugamed.org/articles/read.dbm?ID=235
John Cerf, DC, is a chiropractor affiliated with the ER at Meadowlands Hospital Medical Center in NJ http://www.hospitaldc.com/
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Re: WHY? - January 24, 2006 8:23:00 AM
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JLS_PT_OCS
Posts: 1684
Joined: January 30, 2005
From: USA
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Hi Jeep. Thanks for posting those.
I don't believe admission to staffs at hospitals (this is the result of legislation, ie it was forced, not the result of a recognized need or unique service requested from the medical world) is proof of anything other than the force of legislation.
I think these posts from Evidence in Motion nicely summarize the difference in direction and applicability between PTs researching and practicing manipulation and DCs researching and practicing manipulation:
http://blog.evidenceinmotion.com/evidence/2006/01/race_for_scient_1.html
http://blog.evidenceinmotion.com/evidence/2006/01/are_pts_stealin.html
I've no interest in staring another PT vs Chiro war, and I think you and I are examples of good providers whose thinking is pretty close together on most things. The fact that you're a DC and I'm a PT is just a coincidence. In fact, without nametags on, someone might not even know the difference in daily practice between us!
I do agree that there are some good things being done in both professions, but the long term outlook seems pretty clear both to me, and to many chiropractors (such as Bob Braile) who write on the topic. That is all I was getting at.
So, I'm not sure if I've been mislead in believing those things, maybe I'm just repeating what I have heard from "chiropractic" sources. As to why THEY might believe those things about their own profession, perhaps you should ask them. But I do have some ideas. :)
Thanks for keeping me on my toes, man. Good to post with you again.
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: WHY? - January 24, 2006 1:49:00 PM
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clydesdale6
Posts: 65
Joined: January 2, 2006
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Well, I see there are more people out there who, like me, see things as grim. I think we just have the wrong focus.
Please allow me to share with you a quick story that unfolded at the hospital i work at.
The rheumatologist walked into the out patient PT dept and was upset that our marketing person posted a flyer advertising a talk that a different rheumatologist was giving in our dept. This talk was also advertised in local papers and we are hoping it will generate interest in an arthiritis program we have. The rheumatologist that was upset wanted to know how we could be allowing his competition to have a talk here at the hospital. He went on to say how much he refers to us, which i would imagine is 3 or less patients a month. He demanded we take the flyers down. He said it was hurting his business.
Same physician, a few minutes later, is giving the spouse of one of our fellow P.T.s an injection for lateral epi. The rheumatologist knows she is a PT, but decides to give her some "education" before injecting her husband, who is a GP physician. THe "education" consisted of: Telling her to palpate her extensor tendon origin while he resists her wrist extension. He then says "you feel that, your wrist extensors actually originate up here in the elbow". I can't make this crap up. Now please dont tell me we need to educate this MD. He has met us before and we have done marketing visits to him in the past. I guess he was just interested in the food and nothing we had to say.
My point is that we are putting way too much effort in things like the DPT. Do you really think the DPT will do anything for this profession? Do you believe you will get more patients or more respect from the MD? It is time to step up and think like the MDs that I have met. Protect your business! For example, we NEED to put an end to the physician owned practices, we need to get real "walk off the street" direct access. We need to generate more revenue. We don't NEED anymore ecclectic approaches and all sorts of abscure treatments that make us look more and more like alternative medicine.
The reason we were marketing a new rheumatologist is that we have to try to tap new referral sources. Why?? Because we lost over 10% of our business to a smaller ortho group that opened their own PT place. The other ortho group accounts for 50% of our business. If they open their own, some of us will be looking for a new job. The friggin MDs make more money on PT than the **** therapists. I have a problem with that. But they have all the power. That is what needs to stop. We need to get real legislation that doesn't allow this to happen. The more we protect with law the better. Than we can go on the offensive and gain some ground back. But we need to stop the bleeding. This is why I cannot recommend anyone to go into this profession, AT THIS TIME. And please dont harp on me with the company line that I dont like PT or I should have not gone into this if i wanted to make money. I am not talking about being rich, at this point I just HOPE to keep getting my lousy 3%/ year. I cant stand the idea of having to work for an MD. They have their place on the healthcare "team".
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Re: WHY? - January 24, 2006 8:47:00 PM
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james097
Posts: 178
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From: West Vancouver BC
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The MDs in America don't take the power, it's PT who are giving it to them. Talk about shooting yourselves in the foot. I suspect American Pts are so far institutionalized and lacking the will to think independently that they have passed the watershed. I sometimes wonder that, with such lengthy extensive education to even enter a PT school that any spirit of enterprise has been washed out. Get patients "off the street" or perish.
Jim McGregor
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Re: WHY? - January 25, 2006 1:36:00 AM
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Jeep
Posts: 353
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From: USA
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Jason-
you claim:
[QUOTE]I don't believe admission to staffs at hospitals (this is the result of legislation, ie it was forced, not the result of a recognized need or unique service requested from the medical world) is proof of anything other than the force of legislation. [/QUOTE]DC staff privledges at hospitals has nothing to do with, nor is it, the result of any "legislation". Could you please cite your source for this erroneous claim?
http://www.hospitaldc.com/
According to the Job Analysis of Chiropractic, a project report, survey analysis, and summary of the practice of chiropractic within the United States, published by the National Board of Chiropractic Examiners in January 2005, 6% of chiropractors in the United States have some type of hospital privileges. This is an increase from 4.9% in 1991 and 5.2% in 1998.
The purpose of my post was strictly to correct erroneous, inaccurate and misleading claims you made relative to DC "Growth" and "Research". Nothing more. It was not a research challenge or who's "best days are ahead" challenge. Our different professions are faced with different challenges and goals. It merely points out that one needs to be very careful of ones sources: not everything one reads on the internet, and internet forums is accurate or true. Sometimes, due to biases, and wishful thinking, we can become victims of bad information, and then go on to spread that "bad information" ----One of the unfortunate aspects of the "internet age".
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Re: WHY? - January 25, 2006 3:50:00 AM
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FLAOrthoPT
Posts: 1011
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From: West Palm Beach
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I think you are jaded and in the wrong place at the wrong time. Think about moving down the road or to another city or state. PT is not that bad as you describe. It is time for you and your practice to think outside of the box a little and stop relying on the traditional heirarchy of medicine which IS and will ALWAYS be physician referral to PT. Market your own patients, get a cash niche going. Find a small time MD or DO who is willing to basically sign off on patients, you get them in the door and if you have direct access, do an eval and then have them see the MD real quick for a prescriptiona nd referral back to you. they MD or DO gets to bill for a quick visit and has all these potential new patients. You can quickly make your own destiny this way. I just think things will always be as you describe in a hospital outpatient setting, lots of deals being made behind all of your backs inbetween departments and supervisors and CEOs regarding the PT dept. Don't take it so personally, just accept it and that you have acafeteria to eat at, or pack up and go else where. I really appreciate your fervor about the problems the profession has, but fighting upstream against the DPT is doing nothing, turn your effort elsewhere. The DPT trend will undoubtedly help the profession in the long run so no need to fight it. Spend you energy on coming up with wellness plans, community programs, cash based ideas like golf performance programs and sports consultation and stop relying so much on one or two ortho groups. My best advice is go hit up all the GPs in town, they do not typically know jack **** about ortho injuries. Volunteer to sit in their office 3 hours twice a week and help eval their ortho patients, in turn you make a direct referral to yourself, you make them look good to their patients and you capture some patients they may have just given a pain killer to and sent home. If this is not feasible, still hit them all up for referrals, 3 a week or so from 10 GPs is better than 10 a week from one ortho group. GPs are typically more willing to hear what PT does and soon they can become a great referral source, let them do the general screen and send them over, tel them they can call ahead and get any of their patients in that day if need be. Just stop whining so much and go do something you CAN do rather than changing the entire world! Small steps that you can actually accomplish is a better step. re group, re focus, take charge, go make the changed you CAN make and start seeing the trees in the forest.
Ben Galin MPT, OCS
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Re: WHY? - January 25, 2006 7:39:00 AM
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JLS_PT_OCS
Posts: 1684
Joined: January 30, 2005
From: USA
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Jeep-
I doubt a site called "hospitaldc.com" is likely to be the unbiased source of information you are asking me to search for.
I don't mean to do the PTvsDC thing, but I work in the federal system and I know for a fact the reason DCs are in as contractors is because of federal legislation mandating it. I'm not sure I could find the name of the bill or something like that, if that's what you mean about correcting erroneous information. The "chiropractic benefit" that is part of the military healthcare system is the direct result of force (federal legislation), not medical necessity or a request from clinicians to have the system expand into other areas. Having said that, the DCs I've worked with in the system are good and have a similar outlook as you do, so naturally it's a good fit, disposition-wise.
We get along great, I don't mean to stir up old wounds, man.
I'm sorry if I come across like I'm waving the PT flag...
And I totally concur with Ben's post.
Not that I don't enjoy the frequent "chicken little the sky is falling" posts by our frequent whiners, because I do so enjoy them. :)
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: WHY? - January 25, 2006 8:49:00 AM
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Jeep
Posts: 353
Joined: March 28, 2003
From: USA
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[QUOTE]I doubt a site called "hospitaldc.com" is likely to be the unbiased source of information you are asking me to search for. [/QUOTE]It appears that you did not bother to click on this link. It is "the American Academy of Hospital Chiropractors" for hospital certification of DCs, you know, the kind non-military people go to. And yes---- it is unbiased. Military hospitals are not the only hospitals. How long have you been "in" Jason? LOL!! There is NO legisislation mandating DC staffing in hospitals outside the military.
You appear to be confusing VA and VA hospitals with civilian hospitals. Yes----VA DC benefits are mandated by legislation, same as PT benefits are mandated by legislation. Medical benefits are legislated. Anything military has to be by legislation, Military IS government and that is THE process.
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Re: WHY? - January 25, 2006 1:23:00 PM
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JLS_PT_OCS
Posts: 1684
Joined: January 30, 2005
From: USA
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Ugh....
I did check the link. I'm glad you state it's unbiased. OK, I'll state chirotalk is unbiased. Thanks for exchanging opinions with me.
There is no legislative requirement for PTs or neurologists or dermatologists at a VA hospital or federal healthcare facility.
They have skills that are required for a hospital to function. This is my point. DCs are in the system because of legislation forcing the issue. No one else is here because of that.
I've been in 14 years, thanks for asking. :)
I'll admit it has been a while since I've been to a civilian hospital, so I can't say whether DCs are standard fare there. Since there evidently is a separate "certification" process for DCs to practice there, that is required by many hospitals (according to the website), I would guess not. Is part of the process promising not to do any of this craziness?
http://www.chirobase.org/06DD/activator.html
http://www.chirobase.org/06DD/ak.html
http://www.quackwatch.org/01QuackeryRelatedTopics/homeo.html
http://www.chirobase.org/06DD/naet.html
http://www.quackwatch.org/01QuackeryRelatedTopics/chironutr.html
I hope so.
I think it's great that some DCs have hospital positions. I think it's a great way for them to differentiate themselves from large segments of their colleagues who do stuff like I mentioned above. More power to them.
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: WHY? - January 25, 2006 6:37:00 PM
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Randy Dixon
Posts: 744
Joined: August 6, 2004
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Well, no DC/PT debate would be complete without me adding, the reason DC's are being added to hospitals is because THE PUBLIC is demanding it.
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