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FLAOrthoPT -> Re: DC's (May 13, 2005 4:09:00 AM)
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when it comes to purely treating a spinal dysfunction and nothing else, you will find PT and DC who treat exactly the same and no discerable difference. In this instance there really is no difference. That being said. The negaitvity comes about from general philospophy of schooling of some (moony) DC.
Most PTs are very logical scientific based, EBM, and will not accept that a manipulation can treat a cold or liver dysfunction. While we know that a facilitated segment could in theory change nerve signals to even organs, it is just too far of a stretch for most PTs to buy into, and we feel that in this scenario a DC is just cheating the public.
We also have resentment of the DC pidgeon holing us into their profession...that is..Pts are taught at entry level to treat all sorts of conditions from wound care to stroke not just spinal conditions. For some reason many DC feel that PTs are only orthopedic spinal in nature and cannot understand why the PT profession exists if they are competent at spinal manipulations.
Another rift exists in the fact that most PTs want to help the pt get better and teach them the skills to be better for a long time...that is primary prevention, avoidance of bad activities, specific HEP, etc. While many Dcs seem to thrive and are even taught specific communication skills to make the pt feel as if they will never get better unless they are fixed by the DC and continue to come in for a predetermined amount of Tx based solely upon XRay or eval but with no concern of reassessing after progress.
Another reason is When the DC treat patients 3 times a week for years and pts go in for their weekly "Adjustment" based solely upon the beleif of subluxtion, then it drives a PT nuts that they feel as if the DC is taking advantage of the pt and moreover the dysfunctions it causes are often close to impossible to treat. I persoanlly hate treating instabiulities from prolonged manipulations, over and over aagin loosening up lig. structures.
Next it seems to drive PTs nuts that "everyone is a candidate for manipulation. Even osteoporotic patients, acutely herniated disks, and even young children. And it seems manipulation, that being their bread and butter, is used to treat even hypermobile situations which just seems inane to most PTs. Now we all know their are some pts who'd rather be fixed than to take personal responsibility for their dysfunctions and would rather have someone stretch them etc, (i make a good living with these pts so I am not going to say anything bad), but it seems that some pts like 16 year old who cannot possibly have that severe of spinal problems are being coerced into regular treatments by a DC. This is just infuriating b/c it not only creates this type of mental attitude of a why me I have back pain at such an early age, but it most likley is creating more problems than it is fixing.
Yes, I'll keep going...Yet another reason their is a rift, b/c of jealousy. PTs feel as competwent if not more than Dc but cannot understand why many pts have such automatic respect for Dc and are willing to pay lotso f cash over a long time, and are willing to go to a DC eevn when in PT, and are the same pts who complain about the 10 dollar co-pay, but will shell out 75 bucks each Dc visit. I think this autonomy and good business drive of a DC drives some PTs nuts out of jealousy.
Overall, I think that there are some Dc out there who'd treat a freshly FRS or ERS patient the same I would and even follow up with a good nm re-ed exercise and good soft tissue work and good behavioral mod teaching, but then again the average DC will not do that and the argument can be made that the avewrage PT does not have enough manual skills to treat some spinal patients. So I think their is a rift based on this untrusting of skill of the average practitioner as well.
Finally, b/c I have to go work, I think the basic underlying philosophy of treating subluxations is not accepted by PTs. So it would be like asking someone with a theological difference to just accept another religion as correct, when deep down they do not believe in the core belief.
The last rift is when a PT or a pt seeing a PT feels the need to go to a chiro simultaneously for the same problem. but it is somewhat understandably maddening for comments like send the pt to a chiro to get their first rib manipulated...in my world, (this is going to sound offensive but it is not I swear) I have no need for DC. I would never send a pt out to a DC, if their was a condition I really couldn't get better I'd either chalk it up to they cannot be treated or refer out to a FAAOMPT or someone at the real top of the field of PT manual ortho Tx. I think that a very good manually trained ortho PT has no need for chiropracters so this creates yet another rift.
So all this being said, the rift between the two professions is understandable and of course prinary reason is turf related and money related like usual. So do I respect a DC opinion i this forum, of course, but yes i shutter when i hear a pt say they go to chiro, mainly b/c it shows me how far behind our profession is at marketing our skills to the general public.
Ok enough for now-
Benjamin Galin, MPT, OCS
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