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Re: Chiropractic Demonstration Project
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Re: Chiropractic Demonstration Project - March 26, 2005 7:51:00 AM
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lynx
Posts: 29
Joined: March 21, 2005
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Jon,
>Further, the practice of chiropractic is:
>>"To examine into the fact, condition, or cause of departure from complete health and proper condition of the human"
>Here's something I don't understand, so I'll ask.
>What exactly is "complete health" and "the proper condition of the human"?
What the law is doing is arbitrarily stating that subluxation an etiological factor (cause) of disease and permitting chiropractors to get reimbursed for misleading patients and going on wild goose chases with their bogus diagnostics like leg checks and nervoscopes to find them.
This causes chiropractors to promote patient dependency and fail to diagnose the real causes of patient complaints.
If state laws had to be congruent with science most of the state chiropractic laws would be invalid.
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Re: Chiropractic Demonstration Project - March 26, 2005 7:54:00 AM
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dross
Posts: 54
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From: NJ
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Jon,
To answer your question about "complete health and proper condition of the human" I have to say, I have no idea, nor does anybody else. Chiropractic legislation is great at wording things so DCs can treat subluxations which they feel is the cause of disease.
I dont understand what this medicare thing is all about. DCs are not going to open labs where they can do blood work. Nobody gets paid just for ordering a test. Chiropractors do not learn clinical medicine. Lab results are part of clinical medicine. How will know what to order, and what to make of the results? It is so much more complicated then seeing a test result and poicking out the one that is out of normal range. I just dont get it.
I dont care about direct access to chiros. If a chiropractor really wants to take on that responsibility then go right ahead. I just hope they let their patients know they have very limited training outside of the spine. I hope people know enough to research this. But its medicare, these are eldery patients, with many conditions. The chiros will drop the ball.
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Re: Chiropractic Demonstration Project - March 26, 2005 8:04:00 AM
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Jeep
Posts: 353
Joined: March 28, 2003
From: USA
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I do not practice in, or am I licenced in, Wisconsin(although it is my home state, and one that I have extreme affection for---- GO Packers!! --if you were born in Wisconsin, you KNOW about the Packer gene!!!))
>>>"To examine into the fact, condition, or cause of departure from complete health and proper condition of the human"<<<
To me, it is incomplete without the entire context. Can you supply the entire context of this? A Badger provider would be the best for this, but I will give it my best. [It is probably akin to the many variences and restrictions PTs have from state to state regarding "direct access"].
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Re: Chiropractic Demonstration Project - March 26, 2005 8:07:00 AM
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lynx
Posts: 29
Joined: March 21, 2005
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Jeep,
Here is some crow for you to eat. That statement was never my opinion and you are the one who is incorrect. The statement comes from judge Moye who ruled on the case.
[QUOTE]
"Referring to CCE representatives, Moye said an aggressive group of leaders of the eight liberal chiropractic schools, who had only one-third of the chiropractic students, had undertaken a series of corporate manipulations to reduce the representation and dominance of the eight conservative chiropractic schools, including Life, who had two-thirds of all chiropractic students."
-Phillip Giltman. "Judge: Viability hinged on ruling", Marietta Daily Journal, 02/14/03.
[/QUOTE]So now it is a proven fact that 2/3 of your colleagues promote overutilization scams.
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Re: Chiropractic Demonstration Project - March 26, 2005 8:11:00 AM
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Jeep
Posts: 353
Joined: March 28, 2003
From: USA
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And the "Marietta Daily Journal" is peer reviewed where?
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Re: Chiropractic Demonstration Project - March 26, 2005 8:16:00 AM
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lynx
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Joined: March 21, 2005
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hahahahah. The evidence was good enough for a federal judge in a court of law. Go ask the judge or reporter.
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Re: Chiropractic Demonstration Project - March 26, 2005 8:35:00 AM
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Jeep
Posts: 353
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From: USA
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If that is what you use as a professional basis........Well then..............
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Re: Chiropractic Demonstration Project - March 26, 2005 8:53:00 AM
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lynx
Posts: 29
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I guess they didn't teach people to concede defeat at his chiro school.
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Re: Chiropractic Demonstration Project - March 26, 2005 9:17:00 AM
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dosrinc
Posts: 335
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From: Bonita Springs
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MPT and Dr. Wagner,
Unfortunately "Physical Therapy" is not a protected term in all states, although the state of Florida Physical Therapy Practice Act states in section 486.151, paragraph d
"Use of the name or title Physical Therapist or Physical Therapy Assistant or any other name or title that would lead the public to believe that the person using the name or the title is licensed to practice physical therapy, unless such person holds a valid license" is prohibited, it also states in section 486.028
"nothing in this chapter shall prohibit any person licensed in this state under any other law from engaging in the practice for which she or he is licensed."
The Chiropractic Practice Act states in section 460.403, paragraph 9b "chiropractic physicians may treat...by the use of physcial means or physiotherapy..."
to my understanding, these provisions are the reason why Chiro's and MD's in the state of Florida can advertise that they perform "Physical Therapy" despite having no PT on staff and there is nothing that the FPTA can do about it.
Rick
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Re: Chiropractic Demonstration Project - March 26, 2005 10:52:00 AM
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coloradojulie
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From: colorado usa
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Rick is right...the term is not protected in Colorado and can be used by chiropractors and physicians as it is considered by the attorney general as a generic term. I have written etc. explaining why it is not, but to no avail. The only thing a chiro can't do is represent themselves as a physical therapist. That term is protected. So I think that with out limited knowledge of other professions and a portion of their expertise, could we all be practicing law? Law is a generic term. Or could we be nursing our patients? Since we manipulate (allowed in Colorado) can we claim to perform chiropractic techniques? Don't we also practice some medicine? Osteopathy? etc etc. And yet our term is not protected! Drives me nuts!
_____________________________
PRC
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Re: Chiropractic Demonstration Project - March 26, 2005 11:39:00 AM
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Jon Newman
Posts: 1697
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From: Amherst, WI
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Hi Jeep,
That quote came from the link provided by lynx and reposted by yourself. I went to Wisconsin and clicked on it. Check it out for full context.
I'm hoping this link will work too. It is the current WI practice act for chiros as per the legislative code web site.
[URL=http://www.legis.state.wi.us/rsb/code/chir/chir004.pdf]practice[/URL]
jon
_____________________________
[URL=http://www.sonymusic.com/clips/selection/30/064887/064887_03_03_30.wav]Evidence[/URL]
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Re: Chiropractic Demonstration Project - March 27, 2005 2:22:00 AM
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Jeep
Posts: 353
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From: USA
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JON-
I read the link to the WI site:
>>>"To examine into the fact, condition, or cause of departure from complete health and proper condition of the human"<<<
This is in the DEFINITIONS section, clarifying and defining what is meant as an "instrument" in the body of the text.
As I suspected, it is indeed was being tauted, out of context, for some posters agenda.
The COMPLETE quote reads:
Chir 4.02 Definitions as used in this chapter.
........
[2]"Instrument" means a devivce employed or applied in accordance with the principles and techniques of chiropractic science, which is used in the practice of chiropractic to diagnose, analyyze, treat or prevent the cause of departure from complete health and proper condition of the human.
If you read further down under "Practice", it states, "use of pocedures and INSTRUMENTS preptory and complementary to treatment of the spinal column, skeletal articulations and adjacent tissue. Diagnosis and anlysis may include: physical examination, speciman analysis, drawing of blood-analysis and the use of x-ray and other instruments."
All this demonstration project is about is, medicare reimbursing, thru a different protocal, that which already within the scope of chiropractic practice. It is NOT about expanding scope that does not already exist.
Chirx-
>>> DCs are not going to open labs where they can do blood work.<<<
Agree. We refer to a lab that does the tests for us. I do not order a lot of labs, but there are times it is prudent patient care as it relates to NMS conditions. eg. yesterday, I sent a patient for RA labs. Fully within my scope, and what is expected/mandated by my practice act.
>>> Nobody gets paid just for ordering a test.<<<
In most circumstances yes, unless it is a physician owned lab.
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Re: Chiropractic Demonstration Project - March 27, 2005 5:49:00 AM
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dross
Posts: 54
Joined: March 16, 2005
From: NJ
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Chirx-
>>> DCs are not going to open labs where they can do blood work.<<<
Agree. We refer to a lab that does the tests for us. I do not order a lot of labs, but there are times it is prudent patient care as it relates to NMS conditions. eg. yesterday, I sent a patient for RA labs. Fully within my scope, and what is expected/mandated by my practice act.
I would hope so. But my question to you is why order the labs? RA is rhematolgical condition best diagnosed and managed by a board certified rheumatologist. If your clinical suspision is high enough to warrant testing then wouldnt be expected of you have the proper physician run the case. When the results come postive are you well versed enough in RA, seronegs, and other inflamatory dz to make a definitive dx of RA? Do you have the experience and tools to manage this case? Som why not let a rheum a handle it from the start? And you treat the joint pain. Thats why chiropractic is under "complimentary health care."
>>> Nobody gets paid just for ordering a test.<<<
In most circumstances yes, unless it is a physician owned lab.
Physicians cant get paid for ordering. You can get paid for perfoming the test if you own the lab, but you can refer to your own lab.
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Re: Chiropractic Demonstration Project - March 27, 2005 8:01:00 AM
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Jon Newman
Posts: 1697
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From: Amherst, WI
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Hi Jeep,
I do like original sources of information, hence my link to the practice act. It still doesn't help me understand what "complete health" or "proper condition of the human" is however.
There are some interesting codes in the demonstration project chiros will be able to bill for; gait training for example. I'm not certain where this fits into the practice act. Is this something you do or other chiros do regularly?
jon
_____________________________
[URL=http://www.sonymusic.com/clips/selection/30/064887/064887_03_03_30.wav]Evidence[/URL]
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Re: Chiropractic Demonstration Project - March 27, 2005 8:46:00 AM
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Diane
Posts: 1493
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From: Vancouver, B.C., Canada
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Here is an example of a chiropractor who calls himself a physiotherapist on his website:
http://www.drkenniemann.com/pages/1/index.htm
Looks like he's in California. Why is this permitted to go unchallenged by the appropriate legal body? Is physiotherapy not = to physical therapy?
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Re: Chiropractic Demonstration Project - March 27, 2005 10:19:00 AM
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lynx
Posts: 29
Joined: March 21, 2005
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physiotherapy (europe) = physical therapy (north america)
physiological therapeutics = chiropractic use of modalities (US, estim)
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Re: Chiropractic Demonstration Project - March 27, 2005 11:33:00 AM
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Diane
Posts: 1493
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From: Vancouver, B.C., Canada
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[QUOTE]physiotherapy (europe) = physical therapy (north america)[/QUOTE]Au contraire mon frere, here in Canada, it is called "Physiotherapy." Last I checked, Canada was still in North America, although some of us would love to unzip the border and tow Canada to Aus or Europe...
Regardless, I don't think PTs in the US should let this kind of stuff get by. Physiotherapy = Physical Therapy = PT no matter how you slice it or whether it is in English or Latin. PTs, where are your state lisencing bodies that could put the boot to this sort of encroachment stuff? This is ludicrous... meanwhile a bunch in Arkansas are going to the mat over who can touch what in what way.
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Re: Chiropractic Demonstration Project - March 27, 2005 12:19:00 PM
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jma
Posts: 2322
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From: NY
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You are right, this person should be reported to the California licensing board, if he is advertising this.
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Re: Chiropractic Demonstration Project - March 27, 2005 2:06:00 PM
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chiroortho
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I agree that chiros (or anyone else for that matter) shouldn't be allowed to refer to themselves as 'PTs' or 'Physiotherapists', and I have no problem with the sentiment expressed here in that regard.
Where I diverge somewhat with the consensus here is in the use of the term 'physical therapy' or 'physiotherapy' as it applies to the use of certain treatments as pertains to generic physical medicine treatments. It's my impression that these treatments are in the common domain, and certainly they're allowed in various state chiro practice acts. In fact, my initial training in the use of modalities was by two PTs, one of which was a department head at a hospital, and the other was the valedictorian of my class (he was the lab instructor). My training in the use of these modalities was absolutely NOT on par with you folks, I'll be the first to admit it.
And I certainly understand your justifiable angst and concern about encroachment on your turf. As you know and are well aware by virtue of the Arkansas nonsense, chiros are very turf-protective themselves. Personally, I'd teach PTs what I know about manipulation tomorrow if I was asked (please don't ask, I'm busy enough already with 4 great kids). :) As far as I'm concerned, manipulation is in the common domain as well, and as long as you get the training more power to ya. I'm not sure that manip can be taught adequately in a course or two, but the excellent Clinical Prediction Rule is starting to make me think that I might be wrong. In fact, I even tried the manipulation on the PT video, and although I don't think I did it well, I certainly don't see why the necessary psychomotor skills couldn't be mastered in a relatively short period of time.
_____________________________
Greg Priest, DC, DABCO
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Re: Chiropractic Demonstration Project - March 27, 2005 4:02:00 PM
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Diane
Posts: 1493
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From: Vancouver, B.C., Canada
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This is what is on the site if anyone wants to know what I'm on about and doesn't want to wait for the page to load.
[QUOTE]WORK HISTORY
Trillium Sports Medicine. Intern and physiotherapist. Performed duties in corrective exercise and rehabilitation,electrical modalities, massage therapy, history taking, NMS diagnosis,diagnostic imaging,etc.[/QUOTE]It's that word "physiotherapist" that he shouldn't use IMHO. Above is a list of all the education he's had. A PT program is not listed. It's like a PT saying on their website that they have practiced as a "chiropractor." Would that not set the hairs on the back of your neck to the full upright position, chiros?
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