Joined: February 19, 2004
Of course he shouldn't, if he isn't a PT. That's a no-brainer for me. Yes, if a PT or anyone else that isn't a DC says that they're a DC, then they're out of line. It's not just bad form, it may very well lead to trouble with boards, etc.
I'm a little flummoxed as to why Ken would do that. The only thing I can think of is that since he performed what he considers to be some of the duties of a PT that he used the term VERRRRRYYYYYYYY loosely. I'm not comfortable talking about him here since he's not here to explain his rationale, but frankly I can't think of a reasonable rationale anyway so I'm not sure that it matters.
In fairness to him, I'm going to email him right away and invite his thoughts on the matter on this board. He's an intelligent man, I'd be interested in his input. Hopefully he can assuage concerns here and otherwise clear it up.
Joined: February 19, 2004
This is a copy of the email that I just sent to Dr. Niemann: [QUOTE]Dear Ken,
On Rehabedge, a PT Forum, I saw a post that raised concerns about your use of the term 'physiotherapist' to describe yourself. You can view the comment at [URL=http://www.rehabedge.com]www.rehabedge.com[/URL] on the Open Forum, and the thread is 'Chiropractic Demonstration Project'.
You'll need to register, but your thoughts would be greatly appreciated.
Joined: March 28, 2003
I am the guy in question.
This whole thing is being blown out of proportion in my view. At Cleveland Chiropractic College in Los Angeles- not to be confused with prestigious clinic in Ohio- I was SPECIFICALLY told to use the term "physiotherapy" in order to avoid confusion with "Physical Therapy".If anyone here thinks I was purposely trying to be deceptive, it is quite the opposite I can assure you.
There must be some term designated for the use of physical modalities such as Ultrasound & E-Stim. I would be happy to change the wording if someone can suggest something similar.
I don't know why Diane went crying to this board because I advised her of the linguistic problems between different countries. Maybe she's getting hysterical because of a heated debate we had in bioethics on the chirotalk board:
Ken, 1. 'Physiological therapeutics', if you must have a catchall term for whatever you were doing with e-stim and ultrasound. Not "physiotherapist." Thank you for your attention to this matter. 2. I'm not "crying" to this board. Steaming, yes.. I think everyone who is a PT should be steaming about this glaring breach of boundaries. The steam will go away when the issue is resolved satisfactorily. 3. There is no hysteria. I save that for when I get r-e-a-l-l-y mad. I'm only about...oh, 4 on a scale of 10. Hovered around 6 earlier today... 4. Best to you too. 5. Thank you to Greg for his facilitation.
You are forgiven for having a school that taught you something so ridiculous as to call modality use "physiotherapy" as a part of chiropractic as if physiotherapy/ physical therapy weren't its own stand alone profession. It's your school that is insulting to PT in that case, not you. Perhaps you could put a bug in their ear about this matter at your next school reunion.
I think the more we stick up for ourselves, PTs, the less this sort of abuse of our designation will occur. Sorry if you felt upset Ken. Thanks again for righting the situation. Nothing personal.
Joined: November 15, 2003
Thought I might come in as a voice from the southern hemisphere, where "physiotherapy" is used in Africa, South America, Australia, New Zealand, Oceania...excluding Antarctica, I believe where physio/physical therapy isn't exactly established. To my knowledge "physical therapy" is confined to the USA, as is "physical therapist". So misuse of "physiotherapy" because it is not a noun used in the USA, is flying in the face of most of the world.
Perhaps, it is wise to check out a few basics before making definitions of what is used where, regardless of whether it is about physio or not.
I won't enter into the argument between physios and chiros - because it isn't really an issue in this country. Chiros use Estim, U/S and other whizzbang gadgets and we are generally moving away from the whole concept; students are generally trained to use the gadgets but are told they probably won't use them - evidence is quite low and their cost is high. But I can understand Diane's concerns, because the situation between PTs and chiros sounds very grey and quite aggro in North America.
It's one thing for various kinds of practitioners to use therapeutic gadgetry, but it's another thing to call oneself a "physiotherapist" as if applying zappers to patients was all we ever did with our degrees.
I believe the term is protected in other countries.. I know it is in my own.
I don't fault Ken anymore. It was his school that erred. All the chiro schools in the US, all 16 of them (shouldn't be a huge job) should be written to by the APTA and informed that use of the term "Physiotherapist" or its English translation "Physical Therapist" or our work, "physical therapy" or "physiotherapy" is out of bounds. That we own that term because that's what we are trained to be, to do, not their students, and they are out of line for suggesting to their students that this is OK and that it can continue.
At least in that case they would know we are watching. Who would like to take that on?
Joined: January 31, 2005
Well, Diane, an excellent suggestion, but I think in some states that term is not protected, and can be used legally by chiros. I can see why they might use it if they could, it has obvious advantages and conveys a lot of meaning to the consumer. I agree that this should be a major issue for us, and pursued forcefully.
I think again, we should be focusing on how each other's services are represented to the public and not on who is allowed to do what. Manipulation does not equal Chiropractic Ultrasound and exercises does not equal Physical/Physio Therapy
I advertise on my business cards that I provide spinal manipulation and manual spine care. The term manipulation is permitted for me to use in my situation. I think there is no problem with a chiro advertising Physical Medicine or Rehabilitation (none of my business what they do anyway), but it's the calling it "Physical Therapy" that really annoys me. That IS my business. Literally. I see this all the time on signage and in the yellow pages. I feel it is dishonest, not to mention the shocking disparity between who can use whose professional name. Lopsided to say the least.
I do think that the fact that direct access got shot down and the chiro demonstration project went through does speak to our political clout, or lack thereof.
I don't think overall that a chiro victory is necessarily a PT defeat. I really feel in the end we are not competing for the same group of patients, and by focusing on quality education, practice, and research standards, we continue to improve our level of respect and expertise within the medical system. That will allow us to build on what successes we have already re: direct access and practice scope challenges to be able to move toward this in the future on a solid base. I think the battle, if we can call it that, for direct access and practice scope challenges with the DCs is really over...we won. It will just take some time to fully realize that, all Arkansas situations aside. I think the writing is on the wall as far as that goes.
Looking forward to when both groups just back off each other, and focus on cleaning up their own back yard...which could use some work, and that's from my vantage point where I can see both sides of the fence...
Hi Jason, [QUOTE]Well, Diane, an excellent suggestion, but I think in some states that term is not protected, and can be used legally by chiros.[/QUOTE]I don't argue the fact they do it, all I'm saying is that it wouldn't hurt to contact them and ask them to stop doing it. Let them know that it's wrong pure and simple. That we exist. That we don't like it their casual use of our designation as if we didn't exist. Be a persistant presence. If they ignore the request from the lisencing body after several polite but firm demands, it would be time to make a stronger fuss. (Well, that's the Canadian way in any case.)
[QUOTE]Looking forward to when both groups just back off each other, and focus on cleaning up their own back yard...which could use some work, and that's from my vantage point where I can see both sides of the fence[/QUOTE]The back yards are being cleaned up on an ongoing basis, the only problem I see is that trash from one side gets dumped into the back yard of the other. That work will be aided when both groups can see the point in building good fences. Good fences make good neighbours. I see clarification of the boundaries around terms that signify separate designations as a start. (Agreeing that a fence is necessary. Buying the wood to build the fence. Building it together. Promising not to crawl over it or dump over it once it is built.)
Then the ongoing work of cleaning back yards can move along sensibly instead of moving trash from one back yard over to the neighbour's back yard, and them wasting precious energy escalating over who trespassed on whom.
Just curious, What do you think the differences are between the patients we see and those that the chiro's see? Believe me they (governing bodies and sufficient rank and file) see us as competition. I for one think that these are exactly the same patients. The profession that most accurately supports it's foundation of practice will win the battle for dominance of non-medical care of the population with musculoskeletal system breakdown and resultant pain conditions.
Jason, good points all My understanding is that the Chiro's and the APTA actually supported eachother (Imagine That!) in each individual groups push for a direct access/increased access demonstration project with Medicare during the negotiations the led to the current Medicare Act. I have mixed feelings about this, on the one hand, a barrier has been dropped, increased access for the chiro's may help with the push for direct access by PT's, on the other hand, if the chiro's screw this up, with overutilization, increased cost to the system and worse yet, any evidence of an increased public safety risk, the doors for PT direct access may remain closed for quite some time. Will be interesting to see how it all plays out. Rick
Joined: March 17, 2005
Just to make you eben more crazy, Maryland Board of Chiropractic Examiners has a seperate board exam for DCs that want to practice "physical therapy." If you pass, you have "physical therapy privledges." I passed it. I have "physical therapy privledges." I dont make the rules, I just follow them (sometimes).
C'mon PTs, get busy. It's ok to make tactical alliances with DCs to get something accomplished, but never make a strategic alliance with them or we get screwed. Don't trust them. As Chirx has pointed out, their schools P*** all over our designation. It's time we toilet trained them.
Don't hitch our wagon to their star. It's a falling star, as Jason mentioned.
Joined: February 19, 2004
[QUOTE]All the chiro schools in the US, all 16 of them (shouldn't be a huge job) should be written to by the APTA and informed that use of the term "Physiotherapist" or its English translation "Physical Therapist" or our work, "physical therapy" or "physiotherapy" is out of bounds. That we own that term because that's what we are trained to be, to do, not their students, and they are out of line for suggesting to their students that this is OK and that it can continue.[/QUOTE]I agree nearly 100% with this statement, but (don't you hate the 'but') my only question is what term would folks here suggest that we use when we're describing our use of modalities? Please understand folks that I'm not asking this with malice or sarcasm aforethought, I'm just curious as to your opinions.
Perhaps just saying that we're using 'modalities', vis a vis 'physiotherapy'? I find the term 'physiological therapeutics' a bit cumbersome and somewhat an affectation.
I want to reiterate that I support you COMPLETELY and without reservation that non-PTs shouldn't describe themselves as PTs or physiotherapists. I'm talking about the procedures themselves, not the title.
It's like the name of my state board is the Florida Board of Chiropractic Medicine, with medicine obviously being used in the generic sense, much as I'd consider what PTs do to legitimately be described as 'physical medicine'.
Greg, how about the term "phsycial agents" or "therapuetic modalities"; Diane, I make it a point to regularly call the local Chiro or DO offices that advertise that they offer Physical Therapy in SWfla and ask to speak to the PT, when they tell me that there is no PT on staff I ask if they feel they are misleading the public by advertising that they perform physical therapy, I usually get a quick hang up, may not change anything but at least they know someone is paying attention. Rick
Joined: February 19, 2004
Rick, I just had an idea that might fly, and that would be 'physical medicine'. In the AMA CPT Code book, modalities are listed under the heading of Physical Medicine procedures, if I recall correctly. I think the terms you suggest might be a little to fancy pants for me. Look at it this way: when my 'Certified Xray Machine Operator' takes xrays, I just refer to her as a 'tech'. I'm not hung up on such things. But I appreciate your thoughtful suggestions. As to the DCs that you refer to in SW Fla, I could be wrong but it may be perfectly legal for them to advertise that way, but I could be wrong. I think part of the Florida board exam includes testing in the topic of 'Physical Therapy'. You can double check if you wish by going to http://www.doh.state.fl.us/mqa/chiro/chiro_home.html and looking up the Practice Act or license exam info.
As an aside, I think there's a little bit of a disconnect here in terms of confusing procedures with titles. PTs are PTs. Physical therapy modalities are in the common domain.
I understand that this may be interpreted here as a fine distinction, but I don't know that the discomfort expressed here is necessary. On the other hand, I don't blame you for being aggravated by the docs that claim that they perform 'Physical Therapy' in their office despite the fact that they don't have PTs on staff. I just tend to think that the PROCEDURE is a different matter than the title. When I tell a patient that we're going to set them up on some physical therapy modalities, I'm not in any way attempting to mislead my patients. My staff members wear name tags that say 'Registered Chiropractic Assistant' and/or 'LMT'.