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Re: Looking like a fool on chiro open forum
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Re: Looking like a fool on chiro open forum - February 25, 2006 11:19:00 PM
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Alex Brenner PT MPT OCS
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From: Kentucky
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Drew,
You are lumping the views of the entire chiropractic profession on the posts of three individuals from that website.
Two years ago there was actually some decent dialogue occurring there; then DOC showed up. The quality of the site has since turned south and now the site in my opinion hurts the profession more than anything. He has single handedly run off all the decent DCs who posted there and has run the site into the dirt. I wonder how many potential DC students have turned from the profession having first read the posts there. Maybe that is what he wants, like the Waffle House there is a DC on every corner in my home town. One Chiro even turned the old car wash into a chiropractic office. I used to wash my old VW bug there when I was in high school, now I just chuckle to myself every time I drive by there. In fact I even considered going in to have an adjustment just so I could tell the chiro that he popped my back where I used to wash my old car.
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Alex Brenner, PT, MPT, OCS
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Re: Looking like a fool on chiro open forum - February 26, 2006 1:06:00 AM
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Dr.Wagner
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From: Indianapolis
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OOOHHHH yes, I was banned...I have been working ALOT LATELY (sorry to those who post in the Medical Complexity Section), I work up, posted the WWJD case then got home at midnight and...I had been erased like a bad case of censorship or book burning.
Likely Scenerio, JAGR (aka Kirk, a weirdo DC in Colorado) complained nonstop to the sight that I was there. Quite honestly, I find the lad unstable and mentally ill. But that is only my professional opinion as a Physician.
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Dr. Wagner DO
Moderator of Medical Complexity Forum
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Re: Looking like a fool on chiro open forum - February 26, 2006 3:36:00 AM
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chiroortho
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[QUOTE]Put atop that the reality that MOST of these guys, like many DC's, think of themselves as clinical superiors to the profession of physical therapy[/QUOTE]Drew, Alex is right, I think most DCs realize the value of PTs and have no problem with them. Sure we try to limit your profession's scope of practice legislatively (as it relates to manipulation), but that is more of a turf battle than anything, kind of like the PTs fighting to keep DCs from using modalities in Pennsylvania. I will state for the record that PTs' knowledge of rehab is much more comprehensive than my own. But I hope you'd admit that DCs' training in manipulation is more extensive than PTs'.
Drew, thank you for your kind comment in my defense on the chiroweb forum.
Turf battles are a fact of life, that's part what we pay our state and national associations for - to advocate for our respective professions and to increase our professional turf - it's nothing personal whatsoever although we all perceive it that way.
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Greg Priest, DC, DABCO
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Re: Looking like a fool on chiro open forum - February 26, 2006 4:01:00 AM
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paulpt
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[QUOTE]But I hope you'd admit that DCs' training in manipulation is more extensive than PTs'. [/QUOTE]There ya go - the opening salvo into the next arguement. I have enough sense not to get overly involved, as the facts have been collated are on both sides of the issue... it gets to the crux of the issue and the issue clearly is the definition of 'manipulation.'
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Re: Looking like a fool on chiro open forum - February 26, 2006 8:38:00 AM
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chiroortho
Posts: 655
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What? Argument? Good grief Paul, I had absolutely NO intention of starting an argument!
What is your definition of manipulation? Maybe I'm missing something here.
All I can tell you is that my entire chiropractic training was centered around and focused on manipulation. That is the MAIN TOOL in the very limited chiropractic treatment toolbox for goodness' sake, and I thought even the most anti-chiropractic person would admit that.
Wow, that post sure took me by surprise. I can tell you one thing, I will NOT argue about it. If you folks disagree, fine. I certainly won't take it personally and won't hold it against anybody that disagrees. Good grief.
Respectfully,
Greg
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Greg Priest, DC, DABCO
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Re: Looking like a fool on chiro open forum - February 26, 2006 3:25:00 PM
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TMondale
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From: Newton-Wellelsley Hospital
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You chiros should go with that good adjusting a subluxation dialogue, as your colleague suggests; that's solid stuff.
Tim
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Re: Looking like a fool on chiro open forum - February 26, 2006 3:32:00 PM
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FLAOrthoPT
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From: West Palm Beach
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greg, do not get discouraged. I'd say you as a profession clearly leave school with much better training on spinal manipulation techniques than PTs. Where we MAY (not all of us, but in basic philosophy) differ is the "when and why" and the "when not and why not" we manipulate. I respect your orthopedic knowledge and skills, and I think when people feel threatened they can lash out at times. Overall, I agree it took me a lot of money and a lot of courses to get proficient at lumbar and thoracic manipulation, I just will not do cervical manipulation I do not feel the reward outweighs the risk, but that is just me. So, let some of that stuff roll off, I'd hate to lose you in these forums..
Ben Galin, MPT, OCS
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Re: Looking like a fool on chiro open forum - February 26, 2006 3:36:00 PM
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Enforcer
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On the DCs only forum someone is showing the misinformation in one of Dr. Ball's posts. Dr. Mirtz came to Dr. Ball's aid but was also shown either misinformed or attempting to mislead.
vt2c1ms you are a troll on the chiroweb open forum. If your work there attracts a bunch of trolls to this site (you may want to learn the different spellings and meanings of site/sight/cite), the folks here may not appreciate you very much.
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Re: Looking like a fool on chiro open forum - February 27, 2006 2:10:00 AM
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GLASGOW
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I generally support Dr Ball's lone stance against chiropractic attacks on physiotherapy.I have just read his latest posts over on the chiropractors open site and can only say I am surprised and disconcerted
at his behaviour which in my mind does not support the image of professional logical physiotherapy.
Perhaps he should try to refrain from being baited and tricked on that site. :o
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Re: Looking like a fool on chiro open forum - February 27, 2006 9:33:00 AM
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paulpt
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Greg: that statement will always depend on the defninition of manipulation... and Ben is making good sense. I will follow his good judgement not to provoke. Suffice to say that we would tread into an emotionally charged nebulous area that would generate new emotionally charged responses that might cause rehab edge to lose good people. Let us follow some good avice, thanks Ben.
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Re: Looking like a fool on chiro open forum - February 27, 2006 10:52:00 AM
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aquatherapysc
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I think we're headed down a slippery slope here. I have a few Chiro friends, I respect their professional opinions and the tangible benefits their treatment methods offer. On the flipside there are poor Chiro's as there are poorly skilled PT's. When we start realizing that both professions have benefits to patients, we'll be better for it.
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Re: Looking like a fool on chiro open forum - February 27, 2006 11:19:00 AM
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vt2c1ms
Posts: 74
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From: Kansas
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Enforcer,
Good day to you also. Since you were on the DC only forum, I take it you are a DC and that's why you are COPYING Doc--which I wouldn't recommend. I will not engage with you on this forum. I'm done engaging in conversations that go nowhere. There are good and bad on both sides--the patients can decide for themselves. Have a great day brother.
Marcos
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Re: Looking like a fool on chiro open forum - February 27, 2006 2:22:00 PM
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Andrew M. Ball PT PhD
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From: Charlotte, NC
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The issue that DC's have with (D)PT's (those that have an issue), isn't patient safety. It's ECONOMIC. They don't honestly thing that we pose a threat to the public. What they fear, is that we pose a threat to their future revenue. That's it. The following is adapted from a recent article in the newsletter of the American Academy of Orthopedic Manual Therapists. I am not surprised to find that the AMA and VHA recognize manipulation as part of (D)PT practice, but I was surprised to see the profession of chiropractic admit this:
In 2004 the Veterans Health Administration (VHA) recognized physical therapists as a provider of manual therapy services including spinal mobilization/manipulation within the VHA. In 1999 Dr. Tom Gustafson, Director of Center for Health Plans and Providers, Department of Health and Human Services stated that physical therapists provide services including manipulative treatment of the spine and other areas for Medicare recipients. In 1998 a code to be used by physical therapists reading; “manual therapy techniques (mobilization/ manipulation, lymphatic drainage, manual traction” was approved by the American Medical Association’s Common Procedural Terminology (CPT) code panel. In 1999 the Virginia Board of Medicine Department of Health Professions was charged to study spinal manipulation and the risk of harm to the public. After intense data gathering, the task force concluded that no limitations regarding the use of manipulation be placed on physical therapists.
The RAND meta-analysis and AHCPR guidelines, frequently cited by “doc” and a handful of other ChiroWeb chiropractors as justification as to why chiropractors alone should be the sole providers of manipulation, is actually a justification of why physical therapists, not chiropractors, should be the primary provider of manipulative services (not that I suggest that DC’s should be barred from providing manipulation). Of the 27 research papers cited in these two landmark
reports, the manipulative services were provided by physical therapists in 12 of the studies compared to only 4 for chiropractors!
Finally, and this was a shocker to me, the Future of Chiropractic Revisited: 2005 to 2015 frequently acknowledges that physical therapists utilize manipulation techniques --- in fact, physical therapists, and the ECONOMIC threat (as opposed to patient safetly threat) posed is mentioned a whopping 26 times!
Drew
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Dr. Andrew M. Ball, PT, DPT, Ph.D.
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Re: Looking like a fool on chiro open forum - February 27, 2006 3:26:00 PM
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chiroortho
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Well Drew of course the chiropractic profession wants to protect their turf, just as the PT profession wants to protect theirs (APTA lobbying to keep DCs in Pennsylvania, if I recall correctly, from using modalities). This doesn't exactly take a genius to figure out. I think it's clear to all of us that the focus is more on turf than patient safety. The DCs don't want PTs doing manip, and the PTs don't want DCs doing rehab and modalities (at least in a few states). Such is life.
How do you folks feel about a DC doing rehab, ie the DC performing rehab in his own clinic?
As an example, here in town is a PM&R MD that has a rehab center with a DC working for him running the rehab center. No PTs.
Greg
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Greg Priest, DC, DABCO
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Re: Looking like a fool on chiro open forum - February 27, 2006 3:52:00 PM
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Andrew M. Ball PT PhD
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From: Charlotte, NC
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I think that we either need to erect fences and respect professional boundaries, or bust them down completely and play on a level playing ground --- not pine for one idea and and sleep with the other. I'd just like to see everyone, (D)PT's and DC's alike, be a little more consistent about the choice. So no, I don't have a problem with any trained DC's doing rehab, so long as no DC has a problem with any trained PT's doing manual therapy and/or manipulation. What I have a problem with, is a DC doing rehab and then trying to say that PT's doing manipulation is inappropriate --- or a PT doing manipulation saying that DC's doing rehab is inappropriate.
Drew
Drew
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Dr. Andrew M. Ball, PT, DPT, Ph.D.
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Re: Looking like a fool on chiro open forum - February 28, 2006 3:19:00 AM
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GLASGOW
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Dr Ball,I think if you read what the DC's generally say on their site you will find that they could not care less what physiotherapy does or does not do.
It seems a simple non-issue to chiropractors and only important to frequent posters like yourself on the chiropractors site. :(
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Re: Looking like a fool on chiro open forum - February 28, 2006 4:07:00 AM
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TLB
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From: Arizona
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Poll Results: Glasgow vs. Dr. Mike (19 votes.)
Is Dr Mike parading as Glasgow just to bait the physiotherapy community and Dr. Ball
89% (17)
Glasgow is a young physiotherapist who will learn in time.
11% (2)
Glasgow, I guess you must have 2 different IP's. Give it up everyone knows who you are and why you are here.
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Todd
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Re: Looking like a fool on chiro open forum - February 28, 2006 4:09:00 AM
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chiroortho
Posts: 655
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Drew, I agree with you completely. Thank you for your rational and polite response.
I think the problem that some of my colleagues have with PTs performing manipulation is that we DCs know how hard it is to learn to perform manipulation well, and that it is a perishable skill. A corollary that might make sense to you is how much time and effort PTs spend learning the intricacies of the many facets of rehab. I will be the first to admit that some of my colleagues buy a theraband and a physioball then start calling it 'rehab'. We can both agree that if DCs are going to perform rehab services, that they need to get the training. Many DCs have done just that, just as many PTs have gone to great lengths to master manipulative therapy.
I support your assertions as noted above, and I thank you for your reply.
Glasgow, I agree with you that most DCs are too busy caring for patients to worry about what PTs are doing, but unfortunately there are a few (DCs and PTs) that feel the need to disparage the others' professions. That is not only non-productive, it is childish. We need to get past that.
Respectfully,
Greg
_____________________________
Greg Priest, DC, DABCO
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Re: Looking like a fool on chiro open forum - February 28, 2006 6:01:00 AM
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paulpt
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Greg - good stuff.
I have a problem with anyone (not just a chiro) calling it physical therapy. Unless done by a physical therapist.
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Re: Looking like a fool on chiro open forum - February 28, 2006 1:39:00 PM
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SJBird55
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Greg, the only problem with your comment on the difficulty of manipulation is beginnning to be proven wrong. (And I've glanced over at chiroweb... I'm just politely bringing up a point and not trying to bait you or any chiropractor.) Read over at Evidence In Motion. I learned manipulation with Childs, Wainner and Bennett - it isn't difficult. (In grad school the physical therapists that taught made all of us students believe that manipulation was difficult and took a lot of extra training.) I know that for me to head to their manipulation course took an act of courage because I had a preconceived notion that the techniques were difficult and dangerous. How absolutely untrue... I honestly can't imagine learning manipulation taking more than say 4 days... granted though, let me qualify that the person taking a 4 day deal does have a physical therapy background.
Generalized techniques do give results. The benefit of specific motion palpation analysis or whatever you call it is appearing to be not as important as many therapists trained in specific manual techniques wrongly assumed. I know my treatment outcomes in amount of disabilty and number of visits has substantially diminished with the population that fits patients with 3 of the 5 factors present in the clinical prediction rule. And also, I generally only do 2 treatment sessions or up to 3 with manipulation over 2-3 weeks combined with a home exercise program and then get the patient involved into other areas of rehab. So, I've never really understood the idea of patients having manipulations by a chiropractor 1x/week for months on end or every 3-4 weeks forever. I really don't get that part (and I honestly don't know how often that happens, but I have had quite a few patients that utilize chiropractic services tell me that kind of thing...).
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