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Re: chiropractors working with PT's
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Re: chiropractors working with PT's - May 25, 2007 9:35:00 AM
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3.5fig
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no...I do understand the distinction he is making, I just disagree with him. Obviously both you and Tim see Chiropractic as the wacky subluxation profession and that is fine. I however, do not see it that way and for every example you can give me of a wacky subluxation chiropractor I can give you an example of a researched based chiro working within the modern evidence based healthcare system we have here in the United States. What good would that do for both of us to that...we can agree to disagree and continue to do the best for our patients....
Have a nice Memorial Day weekend
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Re: chiropractors working with PT's - May 25, 2007 9:38:00 AM
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Tom Reeves DPT ATC
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I am torn with this a bit. I also have a friend who is a chiropractor. We get along great, we play golf and poker together, we just don't talk about the philosophy of chiropractic. He knows what I think so we just don't bring it up. Its almost like Wile E Coyote and the sheepdog. "Morning Ralph" , Mornin Frank" all friendly-like before they punch in and then they "Disagree" all day i.e. wile e tries to nab the sheep and the sheepdog tries to protect the sheep.
He is not a subluxationist, he says, but has a Proadjuster and does behave professionally straight-ish. He refers to the MD/DO clinic in town but will still keep some patients coming for a long time for maintainence.
It is a bit like Lutherans and Catholics. Neither things the other is right, really, but they coexist. Allegedly, they both have the same thing in mind as a goal, the problem with many chiropractors, in my view, is that they aren't Lutherans, or Catholics, or Methodist, or Mormons, or Baptists etc . . . Many of them are Moonies, or christian scientists, or etc . . .
I stop before I offend.
there are many mainstream chiros that I can respect, there are some that are just whacked and unffortunately for the DC profession, they are represented too well in their governing bodies and therefore to the public and traditional medical communities so that is what we think of first.
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Re: chiropractors working with PT's - May 25, 2007 11:08:00 AM
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nari
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Tom,
Well said. As with many professions and occupations, it is the very vocal and odd-believers which present to the public eye and tar the profession's reputation. Maybe some professions attract the oddballs more than others - I don't know.
Sometimes we should look beyond them, and think more about the down-to-earth, solid members of the chiro profession who also have to go along with the Moonies/Loonies whatever.
I would have no problems at all working with a chiro, but they have a different reputation in Oz.
Nari
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Re: chiropractors working with PT's - May 25, 2007 2:31:00 PM
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Rehab101
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Thank you so much everyone who has replied to my original question (about whether or not as a new grad to go into business with a DC). I sincerely hope no one was offended in any way via this question or the answers to it. After taking in everyone's great insights and comments, I have decided not to work with the chirpractor at this moment. Although the money would be great and he works in a fitness/sports injury center that has always been my dream setting to work in, I think it is wiser for me to get my feet wet first by working with other PT's a little and go from there. I think that as a newbie as well, I do not want to dive into billing insurance companies on my own and getting involved with that aspect of the profession just yet. Although I do believe that PT's and Chiro's can actually learn a lot from eachother, I think at this point I am looking more for mentoring and learning from the PT community itself. The money can come later...thanks again so much everyone and if anyone knows some good PT clinics that are located within or affiliated with fitness centers around the san fernando valley in CA, please send over the info...i would love to work in the fitness center/sports injury setting.
Have a great Memorial Day wknd!
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Re: chiropractors working with PT's - May 25, 2007 3:17:00 PM
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3.5fig
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good luck to you in your future. I think that you made a wise choice bye getting your "feet wet". Once you have a few years under your belt you will be able to analyze business opportunities with a sharper eye and you will also have a better understanding of where you want to be and what type of environment you want to work in. I can tell you from my own experience of working with PTs for the past 12 years that I couldn't think of working any other way. It just seems so natural and the give and take that we have is very smooth. I truly see how our professions can work together...
Anyways...good luck to you...
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Re: chiropractors working with PT's - May 25, 2007 3:32:00 PM
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proud
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3.5fig,
Just curious in your experience, what is it that you are doing for the patients that the PT is not? And visa versa?
I suspect it's manipulation but I do not want to assume.
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Re: chiropractors working with PT's - May 25, 2007 4:23:00 PM
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TMondale
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From: Newton-Wellelsley Hospital
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101,
Good luck in your future. If your honest and antrepeneurial, and always strive to deliver the best in non surgical, non pharm. care for the neuromusculoskeletal system you'll make all the money you want, and you don't have to allign yourself with anyone. Find a good PT to learn from, and make the most of it.
It's a very bright future for you and your classmates.
Tim
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Re: chiropractors working with PT's - May 26, 2007 12:01:00 PM
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mcap56
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Here is a more fundamental question. You recently graduated from PT school. Who is going to be there PT wise to answer your questions? Who is going to show you things?
Why don't you consider whether you are able to be on your own. I shudder to think of what some of my patients would have been exposed to had I not sought out a practice where there was always going to be an experienced PT around. And trust me, I was confident.
Marc
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Re: chiropractors working with PT's - May 27, 2007 12:14:00 AM
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nari
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From: Australia
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Marc, I agree. Whether or not there is a chiropractor involved, or any other health professional, experience with other PTs is valuable. Probably essential. There are PTs who go out into solo private practice immediately after graduation and survive quite well, but it is hard.
Nothing like bouncing ideas and thoughts off another PT when one feels unsure about things. Almost as good as a peer review.
Nari
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Re: chiropractors working with PT's - May 28, 2007 5:31:00 PM
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3.5fig
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Proud,
Good question. Your assumption was partially correct. Manipulation plays a big part of what I am doing that the PT is not. And it is not just simple manipulations that one can learn at at seminar. I know that this may cause a debate to arise and it definitely is not evidence based, but....in chiro school, one learns numerous moves(manipulations) that have been developed over the years. It can be compared to the many different mobilizations that can be learned. A simple example would be a patient with a cervicothoracic problem that the PT is having a problem with, I can help with specific manipulations for the CT spine that I have learned in chiro shcool that the PT does not know. I can assess the patient and see if there is anything I can do to help.
Besides manipulation, one of the things that I can do that the PT can't is a nutritional assessment of the patient. A patient with a pro-inflammatory diet is going to be tough to treat and the diet has to be dealt with. That is just one example, nutritional assessments can be very complex. Now, I do not know the current status of the nutritional education of PTs, but the ones I work with graduated over 10 years ago and they got nothing in their course work related to nutrition.
Also, I can assist with diagnosis. A fresh set of eyes can help with the diagnosis and get to the root of the problem quicker.
Hope that helps answer your question
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Re: chiropractors working with PT's - May 28, 2007 7:36:00 PM
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james097
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From: West Vancouver BC
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3.5fig,
Describe this cervicothoracic technique that I may not know about, I am keen to learn.
Jim McGregor
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Re: chiropractors working with PT's - May 28, 2007 8:45:00 PM
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3.5fig
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Well depending on the situation at hand, I could use the modified thumb move, a prone pisiform move, a supine 1st rib, seated gonstead lateral lower cervical, thompson drop table prone, or a supine anterior to name just a few...The choice of each one depends on quite a few variables such as area of complaint, patient's overall health status, size/shape of the patient, has patient been manipulated before, physical findings, pain tolerance, patient's age/gender...etc...
There is more than one technique that can be chosen for any given situation. Which one I choose comes from experience...classroom and real world...
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Re: chiropractors working with PT's - May 29, 2007 2:50:00 AM
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ginger
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From: Melbourne Victoria
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3.5fig, All these different techniques , unless I am not on your page fig, are meant to restore subluxed facet joints to a more correct position , am I right?
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Re: chiropractors working with PT's - May 29, 2007 6:05:00 AM
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3.5fig
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Well, if I was a subluxation based chiropractor that is what I would probably say...although I can't speak for them. I do not think that a facet joint is out of position. I look at it more as restoring proper motion to the joint. The choice of the different technique really depends on those variables that I listed. I tend to perform certain ones more than others, but it all depends on the situation at the time...
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Re: chiropractors working with PT's - May 29, 2007 6:55:00 AM
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Lehmkuhler
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The "bone out of place" idea is dying within chiropractic as the newer generations of DC's are generally functionally oriented.
And within the field of chiropractic, very few people can/will adjust the ct junction. I find that it's one of the most important areas I can address.
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Re: chiropractors working with PT's - May 29, 2007 1:35:00 PM
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ginger
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From: Melbourne Victoria
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Fig and lehkuhler, on that same note , roughly how many manipulations does it take to restore normal spinal movement and be redundant in your practice ?, average.
_____________________________
Ubi est mea anaticula cumminosa?
The Grand Pediculator
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Re: chiropractors working with PT's - May 29, 2007 3:02:00 PM
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Lehmkuhler
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Completely case by case. Sometimes one. Sometimes we offer symptom relief of a condition that will never be truly gone.
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Re: chiropractors working with PT's - May 29, 2007 3:21:00 PM
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JCOY
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[QUOTE] Fig and lehkuhler, on that same note , roughly how many manipulations does it take to restore normal spinal movement and be redundant in your practice ?, average.
[/QUOTE]I think you may have some misinformation as to what DCs do, and how they manage patients, patient cases, and patient conditions. We do not measure it in terms of "manipulations"
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Re: chiropractors working with PT's - May 29, 2007 3:42:00 PM
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proud
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3.5fig,
Yes that did answer my question. Of course I will disagree with you on the specificity of your manipulation. That includes the CT junction. How do you know that "that" segement needs "motion restored"? Fact is you don't...
Funny that Cleland has shown thoracic spine manipulation can be useful in a sub-group of patients with neck pain. Isn't it?
Anyway, those PT's you are working with sound to me to be slightly out of touch with where the PT profession is currently. They should be encouraged to upgrade their skills quickly. Perhaps if they had a PT mentor, they would figure that out...
Every PT should know how to effectively and safely manipulate the spine from the lower C-spine down. If they do not know, they lose out on a powerful neurmodulatory technique that can be beneficial in about 10-15% of the patient population. Manipulation is far from a required skill, but it is a neat little clinical trick that a reputable PT should not have to rely on anyone else to perform for them really.
I refrain from the debate about learning a plethora of techniques and the requirement for that sort of overkill. In my opinion, if manipulating a region is that difficult, there are other means to achieve the same neuromodulatory goal. My opinion...feel free to disagree. Others have. I still think I am correct.
And in Canada anyway, dieticians require a 4 years university degree to provide "nutritional councelling and assesment". I am not convinced that a chiro OR a PT should consider themselves qualified to provide this service. In Canada anyway.
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Re: chiropractors working with PT's - May 29, 2007 4:14:00 PM
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JCOY
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However, If you have NO dietary background, NO nutritional background, how do you know when "dietary" consultation may be warrented?
Proud-
-What is your educational nutritional background?
-How many credits/hours did you have in nutrition?
-How many of your patients have you referred for nutritional consultation?(obvious obesity not included).
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