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Re: How do I know if manipulation is legal in my state?
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Re: How do I know if manipulation is legal in my state? - August 12, 2005 10:09:00 PM
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Randy Dixon
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9)(a) "Practice of chiropractic medicine" means a noncombative principle and practice consisting of the science, philosophy, and art of the adjustment, manipulation, and treatment of the human body in which vertebral subluxations and other malpositioned articulations and structures that are interfering with the normal generation, transmission, and expression of nerve impulse between the brain, organs, and tissue cells of the body, thereby causing disease, are adjusted, manipulated, or treated, thus restoring the normal flow of nerve impulse which produces normal function and consequent health by chiropractic physicians using specific chiropractic adjustment or manipulation techniques taught in chiropractic colleges accredited by the Council on Chiropractic Education. No person other than a licensed chiropractic physician may render chiropractic services, chiropractic adjustments, or chiropractic manipulations.
I think it remains unclear if manipulations are prohibited or "chiropractic manipulations" are prohibited. However, if I were a judge or juror I would think the intent of the law is to prohibit spinal manipulations by PT's.
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Re: How do I know if manipulation is legal in my state? - August 13, 2005 3:22:00 AM
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FlaDC
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Randy, I think you might be trying to split hairs. Fl appears pretty straight forward; "The practice of physical therapy as defined in this chapter does not authorize a physical therapy practitioner to practice chiropractic medicine as defined in chapter 460, including specific spinal manipulation".
When I read it, it appears clear to me that only chiropractors may perform manipulation to the spine.
what I am saying is that I would not want to be a PT and be accused of performing a "spinal manipulation" under this wording. Then it would be open to the interpretation of the courts, and that would most likely depend upon who had the better expert witnesses. If I were a PT, it would be a can of worms that would not seem worth opening, in terms of stress, and expense attemtping to defend.
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Re: How do I know if manipulation is legal in my state? - August 13, 2005 3:48:00 AM
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SJBird55
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Nah, FlaDC... it would simply come down to whether a "pop" was heard... case over and done.
So... that means, all of us PTs need to specifically state that "no cavitation" occurred.
Maybe the key is in "specific" manipulation... I only know generalized techniques and those that taught me could not tell me what level would be affected...
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Re: How do I know if manipulation is legal in my state? - August 13, 2005 6:23:00 AM
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Alex Brenner PT MPT OCS
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FlaDC,
When a PT manipulates a spine he is not performing chiropractic. Chiropractors "adjust" the spine to fix subluxations and to allow the innate spirit to flow freely and heal the body. Wouldn't you agree that what a PT and Chiro do are very different?
I manipulate spines very often in my clinic to help restore motion and decrease spine pain and disability. Is this chiropractic?
I am not trying to realign anything or release the compression on an innate spirit.
_____________________________
Alex Brenner, PT, MPT, OCS
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Re: How do I know if manipulation is legal in my state? - August 13, 2005 7:36:00 AM
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scheiropractic
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Alex, Innate intelligence is not a spirit, its a name given to the physiological processes occurring in the body, to maintain it and adapt it to stresses it is subjected to.
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Re: How do I know if manipulation is legal in my state? - August 13, 2005 7:57:00 AM
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Alex Brenner PT MPT OCS
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From: Kentucky
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Thanks scheiro. Would you agree that what we do is very different? Why would a chiro think that when PTs manipulate spines we are tyring to practice chiropractic?
Also, correct me if I am wrong, but isn't manipulation an osteopathic term not a chiropractic term. PTs learned their manual manipulative techniques from osteopaths hence why we call what we do manipulation. Adjustment is the chiro term. Correct?
_____________________________
Alex Brenner, PT, MPT, OCS
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Re: How do I know if manipulation is legal in my state? - August 13, 2005 10:30:00 AM
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FlaDC
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Alex, in theory agree with you. However, I have met a few PT's in my state who have been bold enough to admit they manipulate the spine just like I do, using the same techniques. Whether they do, or not doesn't matter to me. I am not threatened by what they do in their own facility.
However, whether this matters to a state board is a horse of a different color. Given what I can deduce from the Arkansas situation, it would appear to me that the PT in question was set up to be caught performing a procedure his state may or may not have sanctioned him to perform. A private investigator entered under the pretense of being a patient, the PT performed a manipulation and the doors slammed shut.
my point is, we should all be aware of what our state practice acts allow us to do. And I wouldn't want to be the one to test the waters, because defending yourself before any state board can be very expensive, not to say stressful. Often times state boards behave much like kangaroo courts--they are like a circus.
While I have never had to come before my state board, and I take great pains to insure that I never do, I have seen friends called for what I would consider mickey mouse nonsense.
I would think twice, or maybe three times before doing anything about which there might be a question.
while adjustment is more of a chiropractic term, manipulation might be interpreted by the courts as the generic term--encompassing the adjustment.
You will also not find the term "innate" written into any state practice act. I don't believe that defense will fly.
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Re: How do I know if manipulation is legal in my state? - August 13, 2005 10:32:00 AM
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pkimm
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I have nothing to say about PT's giving manipulations, but I think that manipulations and adjustments are same thing with diff term. ( I think that these terms were created becasue of political reasons)
ie: I'm driving a car, instead of automobile.
To put it in a nut shall, I think that, PT's and DC's started from two diff beginnings, but we are heading in the same direction. We both specialize in physical medicine and our main goal is to make patients make feel better.
I'm sure not all people will agree with me, but i'd say we have more similarities than differences
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DC Student
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Re: How do I know if manipulation is legal in my state? - August 13, 2005 10:36:00 AM
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Randy Dixon
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Fla,
Splitting hairs is what law is all about. I agree with what you say, that it would be risky and challengeable for a PT to practice manipulations in that state, but I'm not sure that they couldn't win in court.
I think a "specific" spinal manipulation qualifies as a term and is differentiated from a "general" spinal manipulation, I also think that there is some confusion about whether the acts are protecting "chiropractic" or preventing non-chiropractors from performing any spinal manipulation. The two are not synonomous.
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Re: How do I know if manipulation is legal in my state? - August 14, 2005 12:40:00 AM
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scheiropractic
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Alex, I think the intent behind what a chiropractor and a PT does is very different.
If a PT uses manipulation that may be very similar in procedure to a chiropractic adjustment
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Re: How do I know if manipulation is legal in my state? - August 14, 2005 5:23:00 AM
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Diane
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[QUOTE]I think a "specific" spinal manipulation qualifies as a term and is differentiated from a "general" spinal manipulation, I also think that there is some confusion about whether the acts are protecting "chiropractic" or preventing non-chiropractors from performing any spinal manipulation. The two are not synonomous.[/QUOTE]Bingo Randy.
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Re: How do I know if manipulation is legal in my state? - August 14, 2005 9:42:00 AM
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dosrinc
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From: Bonita Springs
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FlaDC,
although I do admit that the wording of the practice act is confusing and could be misconstrued in a court of law, it seems that any PT in Florida who was taken to court for performing manipulation/mobilization would have the full support of the FPTA, their position is as follows:
Whereas, the Normative Model of Physical Therapist Education, a consensus-based model for physical therapist professional education, includes the interventions of joint mobilization/manipulation and soft tissue mobilization/manipulation: and
Whereas, the Guide to Physical Therapy practice, the profession's description of physical therapist practice utilized by physical therapists, health care policy makers, managed care providers, and others, includes the intervention of joint and soft tissue mobilization/manipulation as components of the scope of physical therapist practice; and
Whereas, the American Physical Therapu Association's position Scope of Physical Therapist Practice includes the intervention of mobilization/manipulation;
Therefore, it is the position of the Florida Physical Therapy Association that mobilization/manipulation is within the scope of practice of the physical therapist.
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Note that mobilization/manipulation are used as interchangeable terms and no grading system is utilized in this wording, there is also no exception given for spine work.
In my opinion, this position statement is the FPTA's attempt to protect the right of PT's in florida to perform manipulation regardless of grade or body part without subjecting the Practice Act to the obvious dangers inherent in opening it for change. This is a step in the right direction and offers the PT some sense of security but I still would not volunteer to be a test case in this state.
Rick
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