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ORIGINAL: 3.5fig

SJBird,

How do you define Physical Therapy?  You stated that "physical therapy" is only legally provided by a physical therapist, which is absolutely true.  What is Physical Therapy?  I know that I can't call what I do Physical Therapy because it is against the law.  Yet all day I am prescribing exercises for patients, doing modalities, manipulating, joint mobilizing, soft-tissue mobilizing, gait analyzing, etc....  Am I practicing Physical Therapy? 

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There is never a shortage of chiros claiming to perform Physical Therapy or be Physical Therapists, yet the opposite is never true. Why is that?

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ORIGINAL: 3.5fig

Oak,

You miss my point.  I was trying to make the point that in a lot of areas Chiropractors and Physical Therapists do the exact same thing and that too much time is spent on turf wars as opposed to what is needed to get patients well.  That was the beauty of what I did this weekend.  The room was full of professionals all striving to learn more in order to improve the lives of the people they treat.  Darcy Norman PT made a great point when he said "In order to work as an effective team you have to leave your ego at the door"  and "If you are doing something that is getting the patient well faster, I need to step back and try to learn what it is that you are doing".

The professionals I work with all have there areas where they excell and we use the team approach to care.  It would never work if one saw me doing gait analysis and got mad because I was doing "PT" and that I should not do that and should refer the patient to him/her just because of the initials after his/her name.  Maybe the difference here is I am referencing my world and you all are referencing your worlds.  Obviously they seem to be quite different.  I tend to stay away from turf wars.  What is the point?  Both sides have their respective political goals which usually are geared towards self-preservation.  Maybe I should just return to my own little world and leave the rest to you all....

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ORIGINAL: SJBird55

Yep, I believe the people of each profession should be respectful of each other also, Oak.  Respectful does not insinuate that everyone has to agree with each other. 

Frankly, I firmly disagree that patients require any type of team approach between a physical therapist and a chiropractor - that approach substantially increases costs:  2 evaluations and a slew of radiographs that aren't necessary.  Literature indicates that unnecessary diagnostic testing can lead to increased fear and anxiety.  Increased fear and anxiety can also increase costs because the higher the level of fear and anxiety the slower the progress via a cognitive behavioral approach.  Also a team approach sends mixed messages to a patient - one message that the patient is required to be dependent on a provider for the rest of his/her life for health and wellness (from the chiropractor) and a completely opposite message that the patient can be independent and manage him/herself (from the physical therapist).  Talk about confusion!  How exactly can a positive be gained when the philosophies are at completely opposite spectrums?

Manipulation has been around for ages.  In fact, the sad thing is that back when I was in grad school, the perspective in my program was that it took years to learn manipulation.  That's so wrong.  There isn't anything difficult involved in performing manipulations.  Recent research in the last 5 years or so is indicating the importance of knowing when to manipulate to have the positive outcomes.  With the appropriate subgroup of patients, only 2-3 treatment sessions with manipulation are even required.  This is in complete opposition of what is typically seen in the world of chiropractic treatments.

Now... the truth of what I see.  Chiropractic care isn't reaching the desired outcomes.  In some instances, in that 10% of chiropractors, they are adding rehabilitative interventions because manual interventions alone generally do not provide the best outcomes.  Physical therapists aren't moving in on anyone's turf.... a small percentage of chiropractors are moving in on the turf of a physical therapist.  If the key concern was the patient, why would a chiropractor broaden the approach versus just referring a patient to a physical therapist who has years of training with a focus on rehabilitation?  It really isn't just a political goal of self-preservation for chiropractors, it is completely financial in nature and increases revenue AND no one can stop you from doing it because we, the physical therapists, do not own those CPT codes.  The only way we can put a stop to the situation would be in 2 avenues:  somehow change the CPT definitions to such a degree that "physician" doesn't equate to chiropractor.  I've never looked into the definition of "physician," maybe chiropractors aren't even supposed to be using the physical medicine and rehab CPT codes.  Hmmm.... The other way to put a stop to the situation is as TLB suggests.

And, yes, 3.5fig... if you were in my backyard and doing "gait analysis" on patients, you better bet that I'd have a discussion with you.  Refer... refer... refer.