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Re: Chiro Board Fines PT $10,000
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Re: Chiro Board Fines PT $10,000 - September 12, 2003 11:53:00 AM
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nrl
Posts: 121
Joined: May 23, 2002
From: israel
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This discussion is amazing. Kafka would have been proud of this tale.
Some questions if I may:
1. If the chiros seem free to define what manipulation is , aren’t the PTs free to define what mobilization is?
2. why are you alone in this? What is your local organization doing for you ? this is a case in which you must be supported by your org. and peers.
Good luck .
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Re: Chiro Board Fines PT $10,000 - September 12, 2003 5:25:00 PM
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ranvier1
Posts: 2
Joined: February 25, 2003
From: Scottsdale, AZ, USA
Status: offline
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A few thoughts from a lurker to the site:
1) The use of a private investigator to pose as a patient with similar symptoms strikes me as very deceptive. I am curious if the Chiropractic Board or their attorney initiated this tactic.
2) Much is made about the definition of mobilization versus manipulation. I won't even comment about the the discussion regarding popping or noises defining ownership of a manual technique. However, at one point in the transcript, the set-up position for a rotatory lumbar spine mobilization is described as a Chiropractic technique in and of itself. A recent cover of JOSPT has a similar "set-up" position. Obviously, this is a technique within the scope of practice of orthopedic physical therapy.
3) I noted that Mr. Teston, PT has completed a residency in manual therapy from the Ola Grimsby group. If this can happen to such an experienced manual practitioner, we must all take notice.
4) Perhaps this incident will help push more consistent language among various state PT practice acts. Ideally, crossing a state line should not limit scope of practice. This may be a naive view. How can the profession change this?
Respectfully submitted,
Dave
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Re: Chiro Board Fines PT $10,000 - September 12, 2003 5:38:00 PM
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teston
Posts: 38
Joined: August 27, 2003
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nrl,
It doesn't matter what the Physical Therapy Practice Act states when the Chiropractic Board ignores Declaratory Orders written by the Physical Therapy Board. The PT Board stated in their declaratory order that Michael had not practiced outside the scope of the Arkansas PT Practice Act, but the Chiropractic board went ahead with their hearing.
ranvier1,
The chiropractic board paid thier private investigator to pose as a patient. Apparently this is an accepted practice.
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Re: Chiro Board Fines PT $10,000 - September 14, 2003 12:56:00 PM
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ptfan
Posts: 2
Joined: September 13, 2003
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This discussion sounds alot like a turf war to me. I'm neither a pt or a chiro, but I imagine that pt's are better at rehab, and chiro's are better at manipulation, right? On average anyhow. I'd rather go to a pt for rehab, and then go to a chiro if I needed manipulation. Both professions need to be more respectful of their boundaries, and work togather- that would be best for the patient I'd expect.
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Re: Chiro Board Fines PT $10,000 - September 15, 2003 3:25:00 PM
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Matthew Hauger
Posts: 37
Joined: February 11, 2003
From: Hermitage, PA, United States
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Of course it's a turf war. Of course it would be better for the patient if we all worked together. Ultimatly, it's an incredibly stupid issue that just wastes resources and creates continued bad blood between professions. Unfortunatly however, we must fight to keep our scope of practice. Next thing you know we'll (PTs) start getting sued by massage therapists for performing massages. Then we'll get sued by athetic trainers for working with athletes. Then we'll get sued by respiratory therapists for performing bronchial drainage techniques. Then we'll get sued by personal trainers for having patients exercise. Etc, etc, etc. Those scenerios won't seem so far fetched if we prove that our profession is too passive to defend techniques that we've been employing skillfully for many, many years. This is a defensive fight. Notice that we're not suing chiropractors for having their patients do exercises.
Very very stupid.
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Re: Chiro Board Fines PT $10,000 - September 16, 2003 4:15:00 AM
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nrl
Posts: 121
Joined: May 23, 2002
From: israel
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Matthew,
Your words summed up the way this case should be described:
“Chiro board fines a PT for using a technique that PTs have been employing skillfully for many, many years.”
Absurd.
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Re: Chiro Board Fines PT $10,000 - September 16, 2003 11:44:00 AM
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Scanner
Posts: 71
Joined: March 17, 2003
Status: offline
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As a DC, I feel the fine was probably disproportionate to the offense involved if he was guilty (I tried to download the transcript but had problems so I don't know the details).
That being said, I think this turf war was may have been initiated back awhile in PA when PT's sued a DC for advertising "physical therapy performed on premises" or something thereabouts. I beleive it is now in the chiropractic practice acts there (I hold a PA license but don't practice there so I would have to look it up.) to refrain from advertising this.
You know, based on this, I have a sneaky suspicion that PT's drew first blood on this unfortunate turf war. What makes me say that? Well, because DC's are so ****ed politically disorganized and you are so ****ed politically organized. I just don't see the DC's boards doing this as a matter of course.
So, turnabout seems fairplay in these politics, although it sucks for the DC who got made an example of.
Bargain for a reduction in the fine to $2000, shake hands, and go your ways.
Hopefully, the ACA and APTA can arrange a meeting where a truce can be drawn in this turf war, first blood drawn be ****ed. However, I see a better chance of the AMA and the ACA reaching common ground than that happening, with the way the APTA and the ACA have been getting along lately.
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Re: Chiro Board Fines PT $10,000 - September 16, 2003 12:09:00 PM
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ptfan
Posts: 2
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It doesn't matter who started it. Both professions are like kids in a schoolyard. Does either side have the balls or the brains to come to an accord?
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Re: Chiro Board Fines PT $10,000 - September 16, 2003 12:28:00 PM
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nrl
Posts: 121
Joined: May 23, 2002
From: israel
Status: offline
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The “turf war” will probably go on for a long time. That’s the nature of these things (hey, I live in the Middle East, the book on turf ,and other, wars was written here). So we’ll say I do this better or I do that better. DCs shouldn’t declare they practice physiotherapy and pts should not declare they practice chiropractic. This is misleading.
But this thing is totally different. In this instance one profession uses legal loop holes to prevent others, from treating patients the way they should according to their discipline. A red line was crossed here which potentially will hurt both our professions and will certainly hold no benefit to patients.
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Re: Chiro Board Fines PT $10,000 - September 17, 2003 2:26:00 PM
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smarshall
Posts: 28
Joined: March 30, 2003
From: havre, MT, USA
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it's of course no mystery that there is a turf war. to me it's plain that it doesn't matter who started it. i don't believe that PT's suing DC's because the DC advertised that there was physical therapy being performed is similar to DC board suing a PT for doing something that did not violate his practice act. as far as i know, he didn't advertise or inform the patient that he would be doing "chiropractic" on the premises.
clearly, my apta dues should be utilized to hire private investigators to entrap DC's, so we can generate some revenue....
stupid? absurd? yes, can i add a few more?
cheap shot, bush league, garbage, petty.
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Re: Chiro Board Fines PT $10,000 - September 17, 2003 2:57:00 PM
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Scanner
Posts: 71
Joined: March 17, 2003
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Smarshall,
[QUOTE]clearly, my apta dues should be utilized to hire private investigators to entrap DC's, so we can generate some revenue.... [/QUOTE]
You have a misunderstanding of politics. The $10,000 fine will go to the Dept. of Consumer Affairs (or whoever oversees the Chiro. Board in OK), not the chiropractic profession to raise revenue.
[QUOTE]stupid? absurd? yes, can i add a few more?
cheap shot, bush league, garbage, petty. [/QUOTE]
Yes, thank you, I beleive the splitting of hairs in PA of a chiropractor performing "physical therapy" or "physiotherapy" was a cheap shot, stupid, absurd, bush league, garbage, and petty.
It's refreshing to see a PT openly criticize their own APTA.
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Re: Chiro Board Fines PT $10,000 - September 17, 2003 3:47:00 PM
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Bournephysio
Posts: 585
Joined: April 25, 2002
From: Calgary
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Scanner,
I think you are missing the difference between the two cases. Physical Therapy (or Physiotherapy) and Chiropractic are professions. If you are a patient receiving Physical Therapy you would expect that it is being provided by a Physical therapist. If you are receiving Chiropractic you would expect that it is being provided by a Chiropractor.
Exercise, electrical stimulation, manipulation etc, are treatment modalities and don't necessarily suggest who is providing them.
If everyone could use the term physical therapy, how would we maintain our professional identity in the eyes of the public? Likewise for chiropractic. We are a little unfortunate in that the name of our profession sounds generic.
IF you are properly trained in using physiotherapeutic modalities/ exercises, I have no problem with you using them. Just don't call it Physical therapy. Physical therapy is the assessment/diagnosis and treatment by education/exercise/manual therapy/modalities/ergonomics/etc. of patients by a PHYSICAL THERAPIST. It is not ultrasound and a exercise sheet. Likewise I expect that Chiropractors are ok with me manipulating but are not ok with me calling it Chiropractic.
Doug
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Re: Chiro Board Fines PT $10,000 - September 17, 2003 5:52:00 PM
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Matthew Hauger
Posts: 37
Joined: February 11, 2003
From: Hermitage, PA, United States
Status: offline
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Scanner,
If you go through your phone book and find any Physical Therapist that advertises as offering Chiropractic care, I will send you money to help sue him. I will write to the state physical therapy licensing board to offer my complaint and my distate about the blatant false advertisement. I will write to the APTA to let them know that I expect this issue to be addressed.
Physical Therapists are not Chiropractors. They did not go to chiropractic school. They did not pass chiropractic boards and obtain a license to practice as a chiropractor. Therefore, they cannot advertise that they offer chiropractic services.
The reverse is also true. Physical Therapy is not a modality, nor is it a combination of modalities. It is a licensed profession practiced by licensed professionals.
To me it seems pretty cut and dry.
--Matt
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Re: Chiro Board Fines PT $10,000 - September 18, 2003 9:41:00 AM
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smarshall
Posts: 28
Joined: March 30, 2003
From: havre, MT, USA
Status: offline
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obviously, i was being facetious in regards to my comment about generating revenue for the chiropractic board. as far as criticizing my own organization, scanner, i am HOPING your comments about this were indeed facetious as well. if not, sorry for the false refreshment.
two professions with overlap in technique is one thing (we all know there is a great deal of overlap, otherwise there would be no "turf war"); one profession advertising and misleading the public (in that they provide physical therapy (or a PT advertising chiro, for that matter)) is another.
Truly, if this guy was practicing out of his practice act, then there is some justification.
back talk, i agree with you in regards to the risks of manipulation. and you are right, i do not wish to advertise, describe, or perform manipulations.
[This message has been edited by smarshall (edited September 18, 2003).]
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Re: Chiro Board Fines PT $10,000 - September 18, 2003 10:02:00 AM
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nrl
Posts: 121
Joined: May 23, 2002
From: israel
Status: offline
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Backtalk,
Personally I found your post a bit condescending. But that’s probably just me and my imperfect understanding of English..
You seem to doubt PTs qualification to perform manipulation safely, correctly, and in the right situation.
Well, above and beyond the legal definition of PT scope in a certain state, manipulation is an accepted part of PT scope of practiced world wide. I’m sure a lot of chiros don’t like it. But in Europe, Australia, and most countries that’s the way it is.
It is also accepted that pts who manipulate undergo extensive education in x-ray/imaging, etc.
I don’t perform cervical manipulation because, personally, I think the risk outweighs the benefit. But that’s a topic for a new discussion.
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Re: Chiro Board Fines PT $10,000 - September 18, 2003 1:38:00 PM
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Matthew Hauger
Posts: 37
Joined: February 11, 2003
From: Hermitage, PA, United States
Status: offline
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Physical Therapy is most definately NOT a generic term. It is the name of a profession and the care provided by said profession. I will, however, absolutely grant you that it is a generic SOUNDING term.
Semantics, semantics, semantics
dumb, dumb, dumb
Bournephysio was absolutely right, so many of these annoying problems could have been avoided if we just had a more original name. However, the fact is that we don't. We are PTs, which makes us the only ones who can deliver PT, just as chiropractors are the only ones who can deliver chiropractic care and massage therapists are the only ones who can deliver massage therapy and physicians are the only ones who can practice medicine.
All in all very annoying, but we must respect professional boundries in advertising. Not only out of respect for our fellow healthcare professional, but so that the patient can know who he/she is seeing.
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Re: Chiro Board Fines PT $10,000 - September 18, 2003 8:23:00 PM
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Sam B
Posts: 73
Joined: August 6, 2003
Status: offline
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Why not change the name of our profession to physiotherapy, as it is in every other country? Physiotherapy is not a generic sounding name and it is one word.
I am tired of being referred to as a therapist; I'd much rather be a "physio"
Do Chiropractors have time for a full medical history, neuro exam and vertebro-basilar and cervical ligament integrity testing when moving patients through at such a high pace? Most chiro friends I have admit that there is no time for such routine precautionary testing prior to manipulation.
Would you pick up on ALL of those diseases you mention Backtalk? Many of those disorders are obtained from a thorough history and detailed exam. When was the last time you picked up on an anomalous vertebral artery that skipped externally 2 foramen levels. How about that aneurysm? Do you manipulate someone when you don't know the EXACT problem? Most patients referred to PT have been seen by an MD and have had x-rays and frequently an MRI, read by an MD radiologist. Manipulation is never guaranteed as safe, ever.
I can tell you I have had at least 10 or more patients in their 60's/ 70's in the last 2-3 months stating they had their neck manipulated by a chiropractor. Thats pretty scary.
[This message has been edited by Sam B (edited September 19, 2003).]
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Re: Chiro Board Fines PT $10,000 - September 19, 2003 12:12:00 AM
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DC_Student
Posts: 24
Joined: March 27, 2003
From: California
Status: offline
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I think it is disgusting what these chiros did. I hope every single DC doing PT gets his pants sued off his invalid, cheating a**.
Chiropractic is truly a shameless profession.
I hope it becomes obselete soon for the common good.
Nemo
[This message has been edited by DC_Student (edited September 19, 2003).]
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