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Re: CA DC's do "physical therapy"
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Re: CA DC's do "physical therapy" - March 30, 2006 9:56:00 AM
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Enforcer
Posts: 19
Joined: August 3, 2005
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"Enforcer,
Please do not speak to Diane that way. "
DC_Student, sorry but Diane deserves to be talked too far worse than this. She is a self-righteous, narrow minded, self-deceiving, sorry excuse for a human being.
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Re: CA DC's do "physical therapy" - March 30, 2006 10:39:00 AM
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nari
Posts: 1568
Joined: November 14, 2003
From: Australia
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Enforcer
Get a life.
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Re: CA DC's do "physical therapy" - March 30, 2006 11:19:00 AM
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TLB
Posts: 353
Joined: September 13, 2002
From: Arizona
Status: offline
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Back to the topic at hand... We still have DC's on this forum and elsewhere who consider and use the term "physical therapy" for the use of modalities misrepresenting the protected term (in most states) to patients who don't really know any better. It boggles my mind...It also says a lot about the individuals that think this way and their refusal to see the other side of things.
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Todd
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Re: CA DC's do "physical therapy" - March 30, 2006 2:39:00 PM
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SJBird55
Posts: 2438
Joined: May 10, 2004
From: Michigan
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In Transmittal 47, CMS makes it pretty clear that chiropractors are not physicians when considering provision of rehab services. Chiropractors are not allowed to participate in certifications or plans of care.
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Re: CA DC's do "physical therapy" - March 30, 2006 6:39:00 PM
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MinnDasota
Posts: 29
Joined: July 22, 2005
From: NYC
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FlaOrthoPT,
Great post! It can be a touchy subject, but you kept it very fair.
I commend those of you whom have kept a level head on the subject.
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Re: CA DC's do "physical therapy" - March 31, 2006 2:03:00 AM
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Jon Newman
Posts: 1709
Joined: April 24, 2004
From: Amherst, WI
Status: offline
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My understanding is that Diane has been banned from this site. David, I would hope that you would at least have the courtesy to delete the post in which Enforcer calls her "a sorry excuse for a human being" as well as the posts that reference that (including this one).
I'm getting the feeling that people are not allowed to express strong (informed) opinions even if they refrain from ad hominem attacks and that as long as someone's ideas are flexible or manip friendly they can say anything they want about individuals.
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[URL=http://www.sonymusic.com/clips/selection/30/064887/064887_03_03_30.wav]Evidence[/URL]
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Re: CA DC's do "physical therapy" - March 31, 2006 8:01:00 AM
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Barrett
Posts: 967
Joined: July 28, 1999
From: Cuyahoga Falls, Ohio
Status: offline
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Hi, remember me?
In case anyone was wondering, I now understand that being forced off this site was one of the best things that has ever happened to me, and I've been on the Internet for a long time. Over on the site where my writing now appears the discussions are lively, relevant and intricate. A therapist like Diane Jacobs, knowledgeable beyond imagining and generous with that knowledge to a fault, will never be attacked personally by anyone hoping to maintain membership or the respect of any other therapist.
I see that here on Rehab Edge the moderators have instead rewarded Enforcer's vilification by banning an incredibly great mind from the site.
Even I am surprised, and after what was done to my contribution here in an effort to appease advertisers it takes a lot to surprise me.
But I'll be honest, I find myself smiling.
_____________________________
Barrett L. Dorko P.T.
http://barrettdorko.com
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Re: CA DC's do "physical therapy" - March 31, 2006 11:02:00 AM
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goodlooks58
Posts: 425
Joined: October 21, 2002
From: CA
Status: offline
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Hm..since I have read everything...what else should I state to get banned from this site?!
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Re: CA DC's do "physical therapy" - March 31, 2006 11:57:00 AM
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FLAOrthoPT
Posts: 1011
Joined: May 8, 2004
From: West Palm Beach
Status: offline
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Barrett who?
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Re: CA DC's do "physical therapy" - March 31, 2006 12:37:00 PM
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Jon Newman
Posts: 1709
Joined: April 24, 2004
From: Amherst, WI
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Ben,
Do you feel better now that you've asked such a question?
I thought this forum was for constructive discussion.
_____________________________
[URL=http://www.sonymusic.com/clips/selection/30/064887/064887_03_03_30.wav]Evidence[/URL]
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Re: CA DC's do "physical therapy" - March 31, 2006 1:06:00 PM
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TLB
Posts: 353
Joined: September 13, 2002
From: Arizona
Status: offline
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Jon
I'm hoping that you just overlooked the humor in Ben's post. If not it may time for a vacation.
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Todd
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Re: CA DC's do "physical therapy" - March 31, 2006 1:10:00 PM
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FLAOrthoPT
Posts: 1011
Joined: May 8, 2004
From: West Palm Beach
Status: offline
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Actually I do. Thanks for your concern. The irony of your post is almost even making me feel better than before. What was constructive there? Can't bite the tongue? I just love the patronizing comments made by some of you holy-er than thous who come in to make a succint point as you shake your finger back and forth saying tssk tssk. Just because Barrett can hide his disdain in a verbose manner made to hide his true biting intent doesn't make his words any less belittleing or malicious than some of our other colleagues who result to bafoonery and childish name calling. so please do not point a finger at me, I have sharp teeth.
Ben
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Re: CA DC's do "physical therapy" - March 31, 2006 1:27:00 PM
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Jon Newman
Posts: 1709
Joined: April 24, 2004
From: Amherst, WI
Status: offline
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So Todd, was he joking or not? It would seem that he actually does take pleasure in disparaging others and threatening people with his sharp teeth if they call him on the enjoyment he takes in it.
My comments were to highlight a claim made by the administrators at rehabedge. Specifically Dave states "The Forum area is for constructive discussion."
My question is, is it? Is that its primary purpose?
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[URL=http://www.sonymusic.com/clips/selection/30/064887/064887_03_03_30.wav]Evidence[/URL]
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Re: CA DC's do "physical therapy" - March 31, 2006 2:02:00 PM
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TLB
Posts: 353
Joined: September 13, 2002
From: Arizona
Status: offline
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Jon,
I stand corrected, my bad. Maybe I need a vacation.
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Todd
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Re: CA DC's do "physical therapy" - April 2, 2006 12:11:00 AM
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goodlooks58
Posts: 425
Joined: October 21, 2002
From: CA
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Ok, now for the chiros sounding sensible...for some fun reading:
Chiropractic
April 10, 2006, Volume 24, Issue 08
DC NewsUpdate
Can the Chiropractic Profession Find a Road Map to Cultural Authority From Physical Therapists?
--------------------------------------------------------------------------------
Craig Liebenson, DC, practices in Los Angeles Calif. He can be contacted at cldc@flash.net. For more information, including a brief biography, a printable version of this article and a link to previous articles, please visit Dr. Liebenson's columnist page online: [URL=http://www.chiroweb.com/columnist/liebenson.]www.chiroweb.com/columnist/liebenson.[/URL]
Chiropractic continues to suffer from an overemphasis on philosophical and hypothetical beliefs while reliable, evidence-based approaches are ignored. Clinical practice and future research should be informed by both experience and evidence. Is our profession striking the right balance between forming hypotheses (retrospective experience) and testing those hypotheses (prospective evidence)? Cultural authority requires that chiropractic shed the image of the charlatan engaged in premature advocacy and overclaim of unreliable, unproven health care beliefs. A road map for this strategy has been refined, to a high degree, by a related health care field – physical therapy.
An editorial in the October 2005 Journal of Orthopedic and Sports Physical Therapy (JOSPT) quotes the American Physical Therapy Association's (APTA)'Vision 2020:1,2
"By 2020, physical therapy will be provided by physical therapists who are doctors of physical therapy, recognized by consumers and other health care professionals as the practitioners of choice to whom consumers have direct access for the diagnosis of, interventions for, and prevention of impairments, functional limitations, and disabilities related to movement, function, and health. To achieve this goal, APTA's Board of Directors suggests that we should focus our efforts on five key areas: professionalism, direct access, the doctor of physical therapy, evidence-based practice and practitioner of choice. Because a majority of first professional degree programs have now transitioned to the professional doctoral degree and physical therapists can provide direct access care in 39 states, it is clear that we are quickly moving toward the Vision 2020. However, it would be helpful to reflect on where we are as a profession and what it is, exactly, that we want in our journey toward the goals set forth by our national organization."
A related article in Physiotherapy Canada gives a historical overview of the evolution of the PT profession, summarized as follows:4
The Canadian Physical Therapy Association motto is Exercito manugue medica, or "exercise and the healing hand."
By the early 1980s, multidisciplinary PhD programs had been instituted in various universities. "The promotion of rehabilitation services was essential to ensure adequate teaching resources and to meet governmental and societal demands for viewing rehabilitation as a continuum from impairments to social integration. Physiotherapy was one of the disciplines contributing to this area of research."
In the mid-1980s, the PT profession helped articulate the World Health Organization (WHO) model for rehabilitation and the need to see rehabilitation as a continuum from physical impairment to social integration.
Indicators that physical therapy is an evolving clinical science include the profession's theoretical framework; MSc and PhD programs; peer-reviewed publications and professional journals; expanding knowledge base; researchers of international reputation; evidence-based practice; and knowledge translation. The theoretical framework for physical therapy is "pathokinesiology as the science defining physiotherapy." The scientific discipline of physical therapy is "the evaluation and treatment of movement disorders."
In 1998, in the Mary McMillan Lecture, Shirley Sahrmann said, "We must solidify our identity as a profession by developing the concept of movement as a physiological system and by accepting the role of practitioners responsible for a system of human organism. I believe we must be defined by our ability to apply scientific principles for the purpose of diagnosing, treating and preventing the movement-related dysfunctions."
PT is building on its scientific base of knowledge: doctoral degrees, publication in peer-review journals, textbooks authored. It is promoting evidence-based practice. Sharon Wood-Dauphinee, in her 1997 Enid Graham Lecture, said, "Leadership is involved in defining what the future should look like, in establishing direction, aligning people, motivating and inspiring them to work collectively to produce change which is often dramatic."
A summary of the past 40 years of PT's evolution includes the following: PT is an evolving clinical science specializing in movement disorders; PT is but one rehabilitation science; to promote further development, the profession must work together with members of other disciplines to enhance interdisciplinary research in rehab; and mentorship, leadership and personal involvement are important if PT is to continue to develop as a profession and clinical science.
Some Questions for Chiropractors to Ponder
Is this a model for chiropractic?
Is this a challenge to us?
Is this a warning to us?
Who are we?
Where are our leaders?
What is our vision?
Can we as a profession work collectively toward our goals?
Physical therapists should be commended for their explicit work to improve their ability to care for patients. In summary, they have embraced evidence-based health care; movement disorders; the WHO framework for disabilities and impairments;5-6 peer-reviewed research; interdisciplinary dialogue; and MSc and PhD programs for their best and brightest.
These are all areas in which the chiropractic profession can similarly derive benefit. Chiropractic is a leader in the conservative management of NMS conditions. We have always emphasized restoration of function, rather than mere treatment of symptoms. Chiropractic research has evolved by leaps and bounds over the past few decades. However, there are a number of shortcomings which render us vulnerable to such a broad-based, progressive approach as enumerated by physical therapists. Our academic isolation is a major hurdle for us to overcome, as is our undying support for practice management models that do not emphasize evidence-based care and may even be unethical. Another issue is prioritizing our political goals to protectionist actions against PT's scope of practice, rather than quality improvement of our own clinical approach to care.
For chiropractic to remain competitive in the health care marketplace, we must benchmark ourselves as evidence-based, patient-centered NMS health care providers.3 Otherwise, we risk seeing even less than the 7 percent of population we currently see. To accomplish this, we should become experts not only at getting people out of pain, but also in showing them how to take care of themselves. Then, we can truly say we are offering patient-centered care.
References
American Physical Therapy Association House of Delegates. Vision 2020. HOD 06-00-24-35. 2000. Alexandria, VA: American Physical Therapy Association; 2000.
Childs JD, Whitman JM. Advancing physical therapy practice: the accountable practitioner. JOSPT 2005;35:624-627.
Liebenson C. Benchmarking – chiropractic care and quality assurance in the 21st century. Dynamic Chiropractic, Sept. 12, 1995. [URL=http://www.chiroweb.com/archives/13/19/08.html.]www.chiroweb.com/archives/13/19/08.html.[/URL]
Richards CL. 2005 Enid Graham Memorial Lecture: Physiotherapy and the rehabilitation sciences. Physio Can 2005;57:34-47.
Victorian WorkCover Authority. Clinical Framework for Chiropractors. [URL=http://www.workcover.vic.gov.au/dir090/vwa/home.nsf/pages/chiropractors.]www.workcover.vic.gov.au/dir090/vwa/home.nsf/pages/chiropractors.[/URL]
World Health Organization. International Classification of Human Functioning, Disability and Health: ICF. Geneva: WHO 2001.
lowing:
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Re: CA DC's do "physical therapy" - April 3, 2006 1:40:00 AM
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Sebastian Asselbergs
Posts: 1206
Joined: September 29, 1999
From: Barrie, Canada
Status: offline
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Diane is banned? You have got to be kidding, right?
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Mundi vult decipi
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Re: CA DC's do "physical therapy" - April 3, 2006 2:54:00 AM
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Randy Dixon
Posts: 744
Joined: August 6, 2004
Status: offline
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I am wondering about that too. I am assuming that I missed some of the posts she made, since I have seen several deleted. But I have to wonder what she would say that would get her banned and her posts deleted while this:
"Enforcer,
Please do not speak to Diane that way. "
DC_Student, sorry but Diane deserves to be talked too far worse than this. She is a self-righteous, narrow minded, self-deceiving, sorry excuse for a human being. -Enforcer
is allowed to stay.
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Re: CA DC's do "physical therapy" - April 3, 2006 4:19:00 AM
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drbuddy
Posts: 429
Joined: July 30, 2005
From: Pennsylvania
Status: offline
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Diane was probably banned for her repeated slams against chiropractors. I have no problem with her debating the issues, but far too often she would throw in a cheap shot against all chiros.
By the way, I overlooked an earlier post that debated whether or not chiros were considered physicians for billing purposes and using physical medicine codes. Yes, chiros are considered physicians and we can bill and are reimbursed for not only physical medicine codes, but physician level E/M codes too.
If CMS uses the term physical therapy as it pertains to the demo project, then they are mistaken and you should take it up with them. As I've said before, there are no such thing "physical therapy" codes (other than eval) according to CPT. As for the PT eval codes, dont worry about chiros billing those because we get paid more for the physician level E/M codes.
Sorry for beating a dead horse, but I thought I saw it twitch, so I just wanted to make sure it was out of its misery : )
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Re: CA DC's do "physical therapy" - April 3, 2006 11:03:00 AM
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aquatherapysc
Posts: 34
Joined: June 14, 2005
Status: offline
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The whole war of words between Chiro's and PT's that frequently takes place on this list is not constructive and often inflammatory. I choose to work with Chiro's in correctly diagnosing and treating patients. We are caregivers and should act as such. Our responsibilities lie primarily we the patients we treat. I'm tired of reading this belittling correspondence pertaining to whose better and who knows more. Many guests of this site are caught up in titles and what they can add to the end of their signatures. I am a DPT, the only people who have to know that are my patients; I choose not to use my title or level of education attained as a vehicle to criticize or belittle others. Too often we lose sight of why we got into healthcare in the first place and for me it was to make a difference and to help people lead lives free from pain or discomfort.
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Re: CA DC's do "physical therapy" - April 3, 2006 10:41:00 PM
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goodlooks58
Posts: 425
Joined: October 21, 2002
From: CA
Status: offline
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Aqua: Yes. you are right we all went into the profession to help our fellow human beings but c'mon..does'nt your blood boil a little bit when you see the crap laid out to the naive public out there in the name of a "quick fix". So please, it is ok to vent out some of your feelings sometimes...
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