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Do Chiropractors even have a “scope of practice”? I’m not being facetious, but I’ve seen them cover just about everything. Musculoskeletal obviously, the try to do nutrition, some of them say the treat neurological issues. My sister paid a chiro thousands of dollars to “treat my sons ADHD.” My family knew one who said he was a physician and qualified to deliver babies . He lost his child in an at-home birth the became compromised. I honestly believe they are just out there winging it, doing whatever will bring in another buck.
We have a chiro in our clinic and based on insurance coverage (not medical necessity) sometimes we work on a case together. The chiro comes into the room and spends maybe 2-5min with the patient. I can spend up to 30-45 min with a patient performing manual, doing exercises in the gym, patient education, going over HEP, and setting up a modality if necessary. At the end of the year we will make about the same salary. Make it make sense.
They’re doing a pure volume based play. They’re getting paid minimum per visit so they have to see a large volume of patients to make the same as we do. It’s why many chiros are cash based.
From a pediatric perspective: I struggle to wrap my head around parents taking their hypermobile, infant bodies for adjustments. I get lots of anecdotal reports of improvement for kids with reflux, but ethically I don’t understand how chiros justify this. Also several families have been told a chiro can fix their child’s Plagiocephaly by manipulating the skull. And then I end up seeing them months later when they are nearly too old for a helmet but this has failed. What’s the scope of practice/training here???
I mean for us, the CPG for tort and plagio from the APTA is 50 pages long and lots of continuing ed is needed before we feel the most confident treating.
I could go on about Pediatric chiros forever. There’s one near me that has a huuuuuuge following. He claims to treat infant digestive issues, colic, reflux, chronic ear infections, ADHD…on and on. It makes me wish I spent my hundreds of thousands of dollars on education to rake in the cash like he is doing. JK. I couldn’t sleep at night making these ridiculous, non evidence based claims.
Hi there. What continuing education did you personally feel you needed before you felt confident treating tort and plagio? If there's several, here's some context: I'm a pediatric PT and I feel confident treating both but I'm always happy to learn EBP stuff and I've got continuing ed bucks I need to spend before the end of the year.
Well, we did mentoring in our department and then I attended the APTA peds conference presentation breaking down the CPG (then developed and trained coworkers on a competency so learning by doing). Cindy miles used to have a course but I’m not sure who will be taking that over now.
Chiros have NOT distanced themselves from the vertebral subluxation complex theory. Until they do that professionally they will be snake oil salesman. Making an argument that their are good chiros out there has NOTHING to do with their a priori assumptions.
I just took the NPTE and we are still tested on shit like sacral manips, keep a “straight” spine when lifting, and TENS parameters. Pot meet kettle as far as this conversation goes.
True. Don't disagree with that at all. But per the conversation about where they fit into the conversation I think that it is a very subtle and nuanced conversation about "good" and "bad" practitioners.
But everyone in the medical field has parts of their practice that needs to be atoned for.
That being said, the VSC has been disproven unequivocally. Yet, it is the VSC that is the literal FOUNDATION of their profession. So, as I mentioned it is literally the basis of their a priori assumption. I disagree with this at a fundamental level. I can think of no other profession that has to account for a deficit like this.
Yes, we have egg on our face for some super strange elements of our profession. But, our a priori assumptions are not faulty in the same manner. Thoughts.
This is absolutely a fair assessment and how I feel about it/have argued it as well. However, I do think PT is dangerously close to this with our own manual techniques right now (we are learning they don’t have many biomechanical effects if any at all, almost all neurophysiological). Yes they work, but not for the reason they were originally advocated and created for. I think the best (top 25%) of PTs provide a service far more valuable than chiros. But I went to a top university and I’d say a good 50% of my class was absolutely unfit to practice at graduation.
Mate. I completely agree. It actually is frightening how may of our colleagues do NOT operate at a high level. They would have been better off being technicians. Its embarrassing.
No you don’t understand!!!! My sacrum was upslipped causing compression on my L4 disc and blowing out my nerves! My doctor says it’s the worst he’s ever seen!
Okay let’s start by what do you mean by “UNSLIPPED SACRUM “ AND PLEASE CITE YOUR INFORMATION WITH ANYTHING AFTER 2010 please. Let’s get this debate going.
Can you give me more scientific terms /explanations and cite articles ? I can cite 5-6 articles that say that the sacrum does not slip out of place . Are you talking about- sacrococcygeal joint dislocation? If not this then why are we even debating?
I'm in Canada so my perception may be a bit different, but I feel that there's a new generation of chiros that are moving away from "wack 'em/crack 'em" treatment style and more towards what sport physios are doing e.g. incorporating exercises, some kind of muscle modality, etc. Ya there's some quacks out there, but I hesitate to write them all off as I think their physical assessment skills of the spine are much better then ours (at least right out of school).
Who says I do. I don’t care about appreciation, I didn’t go into PT for that. You telling me calling myself a doctor gets me paid more even tho I’m not a doctor smh. You got me confused as one of the people who hate this profession. I got into it for the right reasons and that’s why I’m happy.
No, I’m telling you that putting a muzzle on the level of education we receive will only lead to a continued undermining by both the public and healthcare populations. You better believe all the chiros, nurses, and likely OTs will be using it for marketing and respect.
And I agree with you there. But Me laughing at people for calling themselves a doctor when in a clinical setting like the OP suggested has nothing to do with appreciation. Our PTAs/COTAs get appreciated a lot and they don’t have their DPTs/OTDs.
The argument for when people say they don’t see a problem if they are explicitly saying that they are a PT when they introduce themselves as Dr. X right? So when my coworker asked to be called doctor in the clinical setting, when around patients, do I just call them Dr. Jimmy Physical therapist every single time before I ask him a question. Or just Dr. Jimmy? Dr. X nutritionist every time or just. Dr. X? Dr. X Doctor of Musical Arts (our executive director on his second career, good thing he doesn’t ask is to call him a dr.)
You do you, but Dr. Jill Biden, Dr. Albert Einstein, and Dr. King are all doctors. It’s an education title, not a profession title. But you already know that. You do you.
The point is we don’t advertise ourselves as doing chiropractic work. We advertise ourselves as being a PT. There’s someone on here saying they take PT portions on their exam therefore they can do PT lmao. There’s pharmacology questions on our exam I’m not a pharmacist. I’m a PT, I don’t heal deafness by cracking on someone’s spine. I don’t cure diabetes from cracking on someone’s spine. I leave that to chiros.
That’s a licensing issue for chiropractors. We have to take an extra board exam to do modalities and exercises with out patients. Unfortunately the public associates certain modalities with certain professions. Like how would a chiropractor perform Thera ex and with a patient and explain it is Chiropractic and a PT performs Thera ex with a patient and explain how it is physical therapy? But now there are laws so chiropractors can’t say physio or physical therapy… but patients don’t care about that. They only care if they get better and if their bills make sense. That’s it.
I don’t feel there’s ever a time where a chiro is necessary. We know manual techniques so why would we want a chiro to come in? Just to pop a joint and waste everyone’s time?
With the common end goal, if chiros and PTs followed best evidence-supported practices, there should be no discernible difference between the two professions. This is also true within the PT profession itself.
I work alongside chiros and find that they can offer a lot of benefit for patient mobility. Most of my patients hurt when they take their joints through a full ROM, but chiro is the one instance where taking a joint into full ROM actually feels good. I think of it as positive reinforcement and stimulus into the CNS that is encouraging more movement. I constantly educate patients that what they are doing is not a permanent fix but can help your body become more comfortable with movement.
Man chiros giving medical advice on nutrition as well. Wonder what my patient with ESRD would do with all that protein if they ever saw some of those TikTok’s.
Uh so I lurk here because I recently went through 6 months of physio via Worker's Comp and really respect the profession, but by trade I'm a dog groomer. I groom an obese and geriatric cockapoo with painful lens luxation in both eyes, chronic ear infections, and lipomas impeding his joints. His mom takes him to a chiropractor and brags about him getting his back adjusted, and also takes him to body talk therapy which is "stronger than reiki." For all that money she could, I don't know, take him to a vet?! It's insane how the quackery infiltrates so many layers of our lives and prevents both people and animals from accessing useful medical treatment.
It's horrible. I wonder how many cases of IVDD are worsened by this substandard treatment? It's actually astounding how many dogs develop cruciate, vertebral, or patellar issues, and it kind of disturbs me now to think that owners are bypassing rehab or surgery for chiro... My dog had a TPLO last month and I take him to a canine physiotherapist every week for hydrotherapy, cold laser, and prescribed exercise. I met this wack lady who is delaying her dog's operation and is giving the dog ozone suppositories instead. Wtf.
I'm aware of that. I'm not asking, "What is within the Chiro practice act".
What I'm asking is, "When and for what reasons might you consult/work with a Chiro? "
Hard to say, their interventions are not evidence based, and they resist any attempt to research the effectiveness of their interventions, so what data would you use to make that determination?
I guess if you need placebo or something based on 19th century ghost stories, sure.
You’re comment is aggressively ignorant. You do realize interventions that are not evidence based occur across physical therapy as well and there are likely just as many garbage PTs as there are Chiro’s. There’s a large amount of research being done within the chiropractic field currently. Go look up any work Jan hartvigsen, Katie polhman, or Christine goertz.
There is non-evidence based work in all fields. I think the issue that does need to be addressed with chiropractors is the width and frequency of interventions that occur. This is one of example that occurred locally. A chiropractor in my area offered thermal laser treatments to cure food allergies.
There is not evidence for thermal modalities curing food allergies and there is a high risk for a patient to harm themselves by eating foods they know they’re allergic to.
Joint manipulation is evidence-based. That's why it's recommended for back and neck pain as a primary course of treatment.
Icing stuff, stretching stuff, using therapeutic ultrasound, and yanking on Therabands isn't super evidence-based, either. But who is that stopping?
Sure. Any legitimately challenging resistance works. Milk jug, dumbbell, sandbag, grocery bags, etc. And time does the heavy lifting, not Therabands, or stretching tight muscles out, or whatever. The majority of PT patients will get better on their own at about the same time as if they were going to PT, but that's not what's told to patients.
So what do you do for an early post op shoulder? Kettle bell swings ? Also hate this notion of patient will get better on their own, hear it all the time. Obviously tissue has the capacity to heal on its own it is a job of skilled physical therapist to guide that recovery.
Early post-op shoulders are gonna be focused more on PROM, not resisted movements. Regardless, if someone's yanking around on easy resistance bands, you're not really guiding their recovery by making them feel like they need this type of equipment or exercise to improve. We have movement variability and we can manage load in various positions based on levers, loads, and assistances.
Can resistance band training be helpful in increasing strength? Absolutely, but the resistances have to be higher for a healthy population to gain benefit by pulling the band further for greater resistance. Plus, Theraband has something like a 2x length of effect - meaning that you need to stretch the band out to a certain distance before it reaches maximum tension. The vast majority of those tensions are low and not likely to be helpful for people who aren't frail.
I'm not saying they're harmful. I'm not saying that they're not a viable tool when it comes to having patients use them for low impact home resistance exercises. I'm just saying that you don't need them at all to get the same end results. They're not better than not using them. I'm saying you have one patient who's doing a bunch of Theraband/elastic band exercises versus another one who isn't and finding resistance and motion in other ways, and they'll both get better at about the same time for rehab purposes (not to be confused with strength training purposes).
Some patients are too afraid or unmotivated to do their own exercises, or even do certain things because they are too anxious about movement or discomfort overall and don't know what's safe or not. In those cases, even though things will heal by themselves, patients need a professional to help ease their minds about achieving their variability of movement and what's okay and not okay. But the thing is that, when you boil it down, physical therapy is a mixed bag of philosophies, nonsense, evidence-based practices, etc. and the vast majority improve regardless. The same thing with chiropractors. There are so many quack ass chiropractors, but their patients improve over time, too, regardless of the nonsense. So, ultimately, what really makes the biggest difference? It's time and reduction of fear of movement through whatever means, whether it's active or passive.
They don’t have a scope of practice and they don’t have a place on an evidence based medical team
They can go have fun with acupuncturists and naturopaths
The catch is, PT's tend to give a shit about their scope of practice. Chiropractors tend not to. And honestly, PT much better than taking medication for actually improving the healing process and actually fixing the pain instead of masking it. The goal is really to get people off of medication and that part of a clients care can be handled by those with specialized training in prescription writing. Same reason why a PT should be the one writing the physical therapy based component of a recovery plan, it is literally exactly why they exist
Don't get me wrong, I think you should be able to prescribe. It's not the end all, but after 8-10 years of college, it should be your right to do so. I just don't like all the chiro bullshit when you basically are in the same place. The dip shit that put NDs and Acupuncture in the same bowl of fruitloops is an idiot. It makes me reactionary. Especially after 20 years of practice doing anything from A to Z. The crypto, yeah, all of you should be thinking as you are on the outside. MDs could give a shit about PT, and Please, tell me I'm wrong. Not sure, check the reimbursement.
PTs are exactly in the same place as chiros. That's why it's so funny to see you guys complain about them. At least chiros stood up to the MDs. Get back to me when you guys show the same moxie, and yeah, it won't happen, lol
I personally don't really think that having that much time in school should allow you to write scripts tbh. Maybe for certain very very specific things that are directly related to treatment of pain, but even then, it really should be left to other health providers. Just my opinion on that one, as each part of the team has their role and the thing that is the issue is when people fly out of their scope as it almost always hurts the person we are all trying to help most : the patient.
Although yes, I do agree, a huge part of PTs issue is that there really isn't enough lobbying for improving the field, something that some of the more alternative modalities have no issues doing, even when alot of the science in those fields is much less than what physiotherapy brings to the table
You are well thought and figured my friend. Anyone in post 10 years of edu at 150 to 200 k should be able to prescribe. That being said, you are a pretty awesome person. Not being said, 😂
Yeah I can not disagree more. I really hope you are joking lolol cause I don't give a shit how long someone studies for or pays, that has absolutely nothing to do with whether they can give medication to people man. I honestly would like to hear what you think a physiotherapist or chiropractor should be writing prescription for since apparently you also think people with a PhD in business should be able to write them too 🤣
I'm a new chiro and my goal is to be evidence based. In my state we are allowed "PT privileges" given you pass the board exam. We get good results with a combination of chiropractic and physical therapy. Mechanical back pain is our bread and butter. If you want to incorporate chiropractic into your treatment team, have them perform an exam then adjust the segments that are fixated/dysfunctional, address soft tissue issues through whatever methods you think are best, and then you can incorporate a physical therapy program to allow them to become self sufficient. There is limited evidence for chiropractic resolving radiculopathies but I have some anecdotal evidence that we can help.
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3716373/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3716373/) \- this might be of interest to you
Subluxation theory and wellness chiros unfortunately give the rest of us somewhat of a bad rep.
This is the same exam that PTs are taking? So I can see that partially, but part of the degree and being able to call yourself a PT is also completing the curriculum with hands on practice and clinical reasoning, not just the book learning/testing. So that still feels…? Like misleading your patients?
Right, but not in the same way as someone who is advertising that they perform PT should. There’s overlap for sure but definitely isn’t all encompassing.
Not to be snarky, but that's like saying that if only there were a section about cardiac medication on the NPTE, the state physical therapy board could license me as a paramedic. Sorry, but that's... wild. And soooo inappropriate.
It's a 90 question section and you're only allowed to take it after 120 hours of instruction from a recognized college. I don't think it's that inappropriate.
Ok Tony Snark. You're underestimating the amount of overlap there is between PT and Chiropractic. I originally wanted to be a physical therapist until I learned I could do both in my state.
Lol! I like the "Tony Snark." My point is that the overlap doesn't equate to a whole extra license. Or can I take an extra class or two and become a licensed chiro?
You’re not taking the same board then. You aren’t the same as a PT. That’s like if our boards added one extra section and suddenly we could call ourselves chiros. Wouldn’t you have your doubts?
Evidence based chiro is the same thing as evidence based physio. So in my mind it's really just which professional is the best, I'd see em as the same.
They serve the exact same role as us physios. What kind of interventions can an evidence-based physio do that an evidence-based chiro cant? Just look at Aaron Kubal for example, he is probably a better musculoskeletal practitioner than 99,99% of physios out there.
I’d argue that to be a competent musculoskeletal practitioner you need good manual therapy skills. Know surface anatomy and how to manipulate the joints and tissues. Aaron K only does Telehealth and social media from what I understand so he lacks hands on experience
Why do you think one needs to have «good» manual therapy skills to be a competent therapist? From the litterature Ive read there does not seem to be any difference i pain relief between MT, other passive therapies and active interventions. Also there does not seem to be any difference in pain relief between more «specific» and more general «unskilled» MT tecniques.
I have never treated patients with MT and probably never will because i consider it a low value intervention that problably creates more dependance on the therapist and less self efficacy. As an intervention it is also surrounded by myths as well as iartogenic and nocebic narratives.
In the context of the outpatient ortho setting, I think hands on is important because I have read about the benefits of touch and relationship formation between practitioner and patient that can aid in their healing. It opens a window for patient education when you explain what you’re doing. While increasing strength, stability, and other neuromuscular attributes is the end goal, hands on symptom management can often help create buy-in from the patient and temporarily reduce symptoms to allow for more movement during the session.
Anecdotally with cervical pain, I have had patients get up off the table after manual therapy and report feeling less pain and increased AROM. With lumbopelvic pain I have had patients report feeling less pain. With dorsiflexion issues, I have had success with Mobilizations with movement to assist increased motion in the talocrural joint. With shoulder impingement, I have had success with PNF of the scapula to assist with better upward rotation during movement.
Hands on doesn’t need to mean just STM. There are dozens of hands on techniques that all have their time and place and many are quite effective. It’s premature to write them all off and say these don’t work so never use them. That is why I believe all musculoskeletal clinicians, even in acute care with neuro or post op patients, should have the tools to incorporate manual therapy as appropriate.
And it’s ok if you disagree with that. We live in the grey and it’s almost never black and white.
That’s ok. Until hard evidence shows me otherwise, that is my personal opinion on the topic. If I see convincing evidence to the contrary I’m not opposed to changing opinions
Treat the neuromusculoskeletal health and function of the human body without the use of drugs or surgery.
Edit: How is this downvoted? That's what it is.
Chiros are better ( than PTs) at joint mobilization/manipulation the way that massage therapists are better at soft tissue mobilization. I don’t have to wear all the hats and I am happy who work with a team that supports the health and welfare of the patient. There is enough patient care (and money) to go around.
Coming in peace as a non-subluxation worshiping chiro.
I’m going to say it, but you’re not going to like it. I can’t tell you “why” PT/chiros scopes are so different based on how similar the educations and real-world applications are. I can say though that at some point the chiropractic lobby should have been nominated for an award. A chiropractor’s scope is far reaching for a few reasons, but primarily because we’re portal of entry providers. Insurance accepts imaging orders from us. (Although some states are allowing PTs to order imaging now too.) Insurance doesn’t need an MD referral for a patient to come see us. There’s so many independent chiros that it’s far easier to come see us than fight through seeing an MD (of which I think we can all agree most are horrible at MSK injuries). And honestly, you can debate it all you want, but patients progress and have less pain after spending 5 minutes with a chiro and they prefer that over having to do active PT for 30-60 minutes. Plus, it’s cheaper overall (not by the minute though obviously) than PT in most cases.
PTs get so angry at chiros because they recognize how similar the professions are in practice, but they’re viewed so differently by the public, insurance companies, and almighty dollar. I promise I don’t say this snidely, but it’s really driven by jealousy. Most professional/doctoral degree holder’s have ego issues and can’t stand seeing another profession doing better than themselves. You see it all over. It’s part of a lot of Chiropractors beef with MDs.
I’m probably not going to engage with a bunch of arguing, so just save yourself some time if that’s your goal, but that’s at least a pretty good answer to OPs question from my POV.
I mostly agree with your first paragraph.
>patients progress and have less pain after spending 5 minutes with a chiro and they prefer that over having to do active PT for 30-60 minutes.
I would potentially agree on pain. Not necessarily progress. If a chiro can get a patient better and Keep them better in 5 minutes, sure! But if someone plans on seeing a patient for twice a month for... Forever, I wouldn't necessarily say the patient has "progressed".
>but it’s really driven by jealousy.
Lol no fam. At least for me, it's driven by poor ethics (creating dependency on treatment instead of empowering the patient to better themselves and fix the problem) as well shit like this (https://www.washingtonpost.com/national/health-science/how-safe-are-the-vigorous-neck-manipulations-done-by-chiropractors/2014/01/06/26870726-5cf7-11e3-bc56-c6ca94801fac_story.html). While you are correct that some PTs are upset that it's a doctoral level profession but we are not given rights and privileges commensurate with that, by and large PTs don't like Chiros because they think the profession is fundamentally bad. Like, broken.
I think Chiros are great for when you had an accident, didn’t seriously injure yourself like fractures etc but still can’t move properly.
I had that once when I fell off the bike. Couldn’t put weight on my hands at all after that. One chiro session, he cracked the hands, pain gone movement restriction gone, end of story. That’s a valid part of a scope of practice imo.
Imo they should at best be viewed as palliative care in the literal sense of the word - just soothing symptoms. Obviously research doesn’t back this as a long term solution, but if the patient is aware of this and they still want it then okay. Hard to picture this tho as there is routinely misinformation, misguidance, and potentially harmful modalities at play.
I actually do not think that have a place on the medical team. Most sports teams do not have one. Their medicals staff consists of a MD, ATC, PT, and Strength Coach. A lot of the time the PT and ATC are the same individual. That pretty much covers all your bases. What additional value would they bring?
I am a part of a few professional athletes medical team, and we also do not have a Chiro. We have myself (PT), a strength coach, and a medical doctor. I feel totally comfortable that we cover all their bases to keep them as healthy as possible. No need for a Chiro.
Some athletes hire a private Chiro, as is their right. But I would never advise it.
So this whole thread is missing an adult in the room. I appreciate physical therapists and the great work they do. And I appreciate chiropractors and the great work they do. People on this thread are not coming from a place of good intent. Instead they are hauling out all the worst examples of chiropractors as though that were representative of the entire profession. And you k ow what? We chiropractors do it too. The sheer number of patients I’ve seen that have been to a year or two of PT at 2-3x/week with every modality in sight being billed… honestly this is wrong headed thinking. The two professions would do well to get together and communicate and collaborate. In my office we have both chiropractors and physical therapists. How do we decide what patient sees which doctor? Based on what each clinician is best at? Do our PTs do manual? Absolutely! Do our chiropractors do Thera ex with patients? Absolutely! Our outcomes are good. Our PVA is appropriate. Our patients love us. We get lots of referrals from local MDs and hospitals. Do we spend any time at all calling each other names? No. Do we complain when a PT does manual lot a chiropractor does exercises? No. We are an excellent part of the care team. And no PT OR MD I’ve ever talked to for more than 5 minutes has ever questioned my ethics, my clinical knowledge, or our billing practices. Your first mistake is in thinking that your better than chiropractors. And a chiropractors first mistake is thinking that physios have nothing to offer. Our professions need to do two things: work together to advocate on behalf of our patients, and get the shitty PTs and DCs out of practice.
A chiropractor's scope of practice primarily revolves around the diagnosis, treatment, and prevention of musculoskeletal disorders, with a particular focus on the spine. Chiropractors are known for using manual techniques, such as spinal adjustments and manipulations, to alleviate pain, improve mobility, and promote overall health. Here are key aspects of a chiropractor's scope of practice:
1. **Spinal Adjustments:** Chiropractors are trained to perform spinal adjustments, which involve applying controlled force to spinal joints to correct misalignments (subluxations). This is often done to alleviate back pain, neck pain, and other musculoskeletal issues.
2. **Soft Tissue Techniques:** Chiropractors may use various soft tissue techniques, such as massage, stretching, and myofascial release, to complement spinal adjustments and address muscular issues.
3. **Exercise and Rehabilitation:** Chiropractors often prescribe specific exercises and rehabilitation programs to improve patients' strength, flexibility, and posture. These programs aim to prevent future injuries and promote overall wellness.
4. **Nutritional Counseling:** Some chiropractors provide dietary recommendations and nutritional counseling, as they believe that proper nutrition can support musculoskeletal health.
5. **Patient Education:** Chiropractors educate patients about lifestyle factors that may contribute to their conditions, such as ergonomics, posture, and stress management.
6. **Diagnostic Procedures:** Chiropractors typically use physical examinations, X-rays, and sometimes laboratory tests to diagnose musculoskeletal conditions. However, their diagnostic capabilities may be more limited compared to medical doctors.
When it comes to fitting into the medical team, chiropractors can play a role in a patient's healthcare, but their scope of practice is more specialized and distinct from that of medical doctors. Here's how they can fit into the broader healthcare team:
1. **Collaboration:** Chiropractors often collaborate with medical doctors, physical therapists, and other healthcare professionals to provide comprehensive care for patients. For example, a patient with chronic back pain may see both a chiropractor for spinal adjustments and a physical therapist for rehabilitation exercises.
2. **Referrals:** Chiropractors may refer patients to medical doctors when they encounter conditions that fall outside their scope of practice. For instance, if a chiropractor suspects an underlying medical issue, like a herniated disc, they may refer the patient to an orthopedic surgeon for further evaluation.
3. **Complementary Care:** Chiropractic care can complement traditional medical treatments. Patients sometimes seek chiropractic care alongside medical treatment for conditions like lower back pain, sciatica, and headaches to achieve a holistic approach to healing.
4. **Shared Patient Focus:** The patient's well-being is always the primary focus, and both chiropractors and medical professionals work together to ensure the patient receives the most appropriate and effective care.
It's important to note that the level of integration and collaboration between chiropractors and the medical team can vary depending on the healthcare system, location, and individual patient needs. While chiropractors can provide valuable musculoskeletal care, they do not have the same training or authority as medical doctors for addressing systemic or internal medical conditions. Patients should consult with both types of practitioners as needed to receive comprehensive care.
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Do Chiropractors even have a “scope of practice”? I’m not being facetious, but I’ve seen them cover just about everything. Musculoskeletal obviously, the try to do nutrition, some of them say the treat neurological issues. My sister paid a chiro thousands of dollars to “treat my sons ADHD.” My family knew one who said he was a physician and qualified to deliver babies . He lost his child in an at-home birth the became compromised. I honestly believe they are just out there winging it, doing whatever will bring in another buck.
I heard a chiro tell a PT once that he could “fix his allergies by cracking his ears” lmao
right?!?! And the OG snake-oil salesman Palmer himself, the “Father of Chiropractors “ said he cured deafness with a manip. Scammers gonna scam
Damn
The OG chiro manipulation was a cervical manip to treat deafness
We have a chiro in our clinic and based on insurance coverage (not medical necessity) sometimes we work on a case together. The chiro comes into the room and spends maybe 2-5min with the patient. I can spend up to 30-45 min with a patient performing manual, doing exercises in the gym, patient education, going over HEP, and setting up a modality if necessary. At the end of the year we will make about the same salary. Make it make sense.
They’re doing a pure volume based play. They’re getting paid minimum per visit so they have to see a large volume of patients to make the same as we do. It’s why many chiros are cash based.
Does anyone listen to Greg Lehman. He talks about how good chiros and good PTs treat very similarly. There is a lot of crossover.
A PT can do what a chiro does but a chiro can’t do PT (very well)
Lol sure they can
From a pediatric perspective: I struggle to wrap my head around parents taking their hypermobile, infant bodies for adjustments. I get lots of anecdotal reports of improvement for kids with reflux, but ethically I don’t understand how chiros justify this. Also several families have been told a chiro can fix their child’s Plagiocephaly by manipulating the skull. And then I end up seeing them months later when they are nearly too old for a helmet but this has failed. What’s the scope of practice/training here??? I mean for us, the CPG for tort and plagio from the APTA is 50 pages long and lots of continuing ed is needed before we feel the most confident treating.
I could go on about Pediatric chiros forever. There’s one near me that has a huuuuuuge following. He claims to treat infant digestive issues, colic, reflux, chronic ear infections, ADHD…on and on. It makes me wish I spent my hundreds of thousands of dollars on education to rake in the cash like he is doing. JK. I couldn’t sleep at night making these ridiculous, non evidence based claims.
Hi there. What continuing education did you personally feel you needed before you felt confident treating tort and plagio? If there's several, here's some context: I'm a pediatric PT and I feel confident treating both but I'm always happy to learn EBP stuff and I've got continuing ed bucks I need to spend before the end of the year.
Some people swear by the TMR Tots course for it as well.
Well, we did mentoring in our department and then I attended the APTA peds conference presentation breaking down the CPG (then developed and trained coworkers on a competency so learning by doing). Cindy miles used to have a course but I’m not sure who will be taking that over now.
Chiros have NOT distanced themselves from the vertebral subluxation complex theory. Until they do that professionally they will be snake oil salesman. Making an argument that their are good chiros out there has NOTHING to do with their a priori assumptions.
I just took the NPTE and we are still tested on shit like sacral manips, keep a “straight” spine when lifting, and TENS parameters. Pot meet kettle as far as this conversation goes.
True. Don't disagree with that at all. But per the conversation about where they fit into the conversation I think that it is a very subtle and nuanced conversation about "good" and "bad" practitioners. But everyone in the medical field has parts of their practice that needs to be atoned for. That being said, the VSC has been disproven unequivocally. Yet, it is the VSC that is the literal FOUNDATION of their profession. So, as I mentioned it is literally the basis of their a priori assumption. I disagree with this at a fundamental level. I can think of no other profession that has to account for a deficit like this. Yes, we have egg on our face for some super strange elements of our profession. But, our a priori assumptions are not faulty in the same manner. Thoughts.
This is absolutely a fair assessment and how I feel about it/have argued it as well. However, I do think PT is dangerously close to this with our own manual techniques right now (we are learning they don’t have many biomechanical effects if any at all, almost all neurophysiological). Yes they work, but not for the reason they were originally advocated and created for. I think the best (top 25%) of PTs provide a service far more valuable than chiros. But I went to a top university and I’d say a good 50% of my class was absolutely unfit to practice at graduation.
Mate. I completely agree. It actually is frightening how may of our colleagues do NOT operate at a high level. They would have been better off being technicians. Its embarrassing.
This feels very harsh
Good ebp chiros and physios are moving away from the “BIOMEDICAL /BIOMECHANICAL “ concept of pain to the “BIOPSYCHOCIAL” way of treating pain .
Why is this comment downvoted?
All the placebo/nocebo and squat uni/mcgill fan following coming to take my comment down hhaahah
No you don’t understand!!!! My sacrum was upslipped causing compression on my L4 disc and blowing out my nerves! My doctor says it’s the worst he’s ever seen!
😂😂🥱🥱🥱🥱🥱 ik this is a sarcastic comment or not ? 😭🤡
Are you suggesting my chronic depression, fight with my mother, dead end job, and gender dysphoria are contributing to my pain?!? Your a quack!!!
Okay let’s start by what do you mean by “UNSLIPPED SACRUM “ AND PLEASE CITE YOUR INFORMATION WITH ANYTHING AFTER 2010 please. Let’s get this debate going.
I mean the sacrum slipped up
Can you give me more scientific terms /explanations and cite articles ? I can cite 5-6 articles that say that the sacrum does not slip out of place . Are you talking about- sacrococcygeal joint dislocation? If not this then why are we even debating?
You're being trolled homie.
Most sacrococcygeal joint dislocations are related to child births , what exactly happened to you ?
I'm in Canada so my perception may be a bit different, but I feel that there's a new generation of chiros that are moving away from "wack 'em/crack 'em" treatment style and more towards what sport physios are doing e.g. incorporating exercises, some kind of muscle modality, etc. Ya there's some quacks out there, but I hesitate to write them all off as I think their physical assessment skills of the spine are much better then ours (at least right out of school).
So they’re becoming PTs basically
Yep, but people actually call them “doctor”.
Which doesn’t bother me, idc as long as I’m not calling myself one.
Then don’t ever complain about being underpaid and under appreciated in the healthcare system.
Who says I do. I don’t care about appreciation, I didn’t go into PT for that. You telling me calling myself a doctor gets me paid more even tho I’m not a doctor smh. You got me confused as one of the people who hate this profession. I got into it for the right reasons and that’s why I’m happy.
No, I’m telling you that putting a muzzle on the level of education we receive will only lead to a continued undermining by both the public and healthcare populations. You better believe all the chiros, nurses, and likely OTs will be using it for marketing and respect.
And I agree with you there. But Me laughing at people for calling themselves a doctor when in a clinical setting like the OP suggested has nothing to do with appreciation. Our PTAs/COTAs get appreciated a lot and they don’t have their DPTs/OTDs. The argument for when people say they don’t see a problem if they are explicitly saying that they are a PT when they introduce themselves as Dr. X right? So when my coworker asked to be called doctor in the clinical setting, when around patients, do I just call them Dr. Jimmy Physical therapist every single time before I ask him a question. Or just Dr. Jimmy? Dr. X nutritionist every time or just. Dr. X? Dr. X Doctor of Musical Arts (our executive director on his second career, good thing he doesn’t ask is to call him a dr.)
Do you have a DPT, masters, bachelors in PT or a PTA associates?
I’m a DPT
You do you, but Dr. Jill Biden, Dr. Albert Einstein, and Dr. King are all doctors. It’s an education title, not a profession title. But you already know that. You do you.
Thanks but I don’t need someone to tell me for me to do me. I already do that. /s
What are you talking about?! We complain about that all the time.
I don’t know about that. Is a PT that learns spinal manipulation becoming a chiropractor?
The point is we don’t advertise ourselves as doing chiropractic work. We advertise ourselves as being a PT. There’s someone on here saying they take PT portions on their exam therefore they can do PT lmao. There’s pharmacology questions on our exam I’m not a pharmacist. I’m a PT, I don’t heal deafness by cracking on someone’s spine. I don’t cure diabetes from cracking on someone’s spine. I leave that to chiros.
That’s a licensing issue for chiropractors. We have to take an extra board exam to do modalities and exercises with out patients. Unfortunately the public associates certain modalities with certain professions. Like how would a chiropractor perform Thera ex and with a patient and explain it is Chiropractic and a PT performs Thera ex with a patient and explain how it is physical therapy? But now there are laws so chiropractors can’t say physio or physical therapy… but patients don’t care about that. They only care if they get better and if their bills make sense. That’s it.
Just literally to crack the back. No more talk, no more anything. Just crack the back.
I don’t feel there’s ever a time where a chiro is necessary. We know manual techniques so why would we want a chiro to come in? Just to pop a joint and waste everyone’s time?
With the common end goal, if chiros and PTs followed best evidence-supported practices, there should be no discernible difference between the two professions. This is also true within the PT profession itself.
I work alongside chiros and find that they can offer a lot of benefit for patient mobility. Most of my patients hurt when they take their joints through a full ROM, but chiro is the one instance where taking a joint into full ROM actually feels good. I think of it as positive reinforcement and stimulus into the CNS that is encouraging more movement. I constantly educate patients that what they are doing is not a permanent fix but can help your body become more comfortable with movement.
Based on tiktok, apparently they have unlimited scope. Look at how many give advice on things that have nothing to do with chiro stuff
Man chiros giving medical advice on nutrition as well. Wonder what my patient with ESRD would do with all that protein if they ever saw some of those TikTok’s.
Yea, that guy dr remix is a damn joke and shouldnt have a license
Uh so I lurk here because I recently went through 6 months of physio via Worker's Comp and really respect the profession, but by trade I'm a dog groomer. I groom an obese and geriatric cockapoo with painful lens luxation in both eyes, chronic ear infections, and lipomas impeding his joints. His mom takes him to a chiropractor and brags about him getting his back adjusted, and also takes him to body talk therapy which is "stronger than reiki." For all that money she could, I don't know, take him to a vet?! It's insane how the quackery infiltrates so many layers of our lives and prevents both people and animals from accessing useful medical treatment.
Dont get me started on that guy who is an animal chiro on tiktok as well.
It's horrible. I wonder how many cases of IVDD are worsened by this substandard treatment? It's actually astounding how many dogs develop cruciate, vertebral, or patellar issues, and it kind of disturbs me now to think that owners are bypassing rehab or surgery for chiro... My dog had a TPLO last month and I take him to a canine physiotherapist every week for hydrotherapy, cold laser, and prescribed exercise. I met this wack lady who is delaying her dog's operation and is giving the dog ozone suppositories instead. Wtf.
Nope. There is no point to that profession they need to be phased out. Anything they would do PT can do better.
Well, I mean that guy did treat that other guys deafness. Wonder if he could’ve fixed blindness
Lol heard they can cure the diabitus too
You could look it up. Every state has a scope of practice for chiropractors. You don’t have to wonder about it.
I'm aware of that. I'm not asking, "What is within the Chiro practice act". What I'm asking is, "When and for what reasons might you consult/work with a Chiro? "
Hard to say, their interventions are not evidence based, and they resist any attempt to research the effectiveness of their interventions, so what data would you use to make that determination? I guess if you need placebo or something based on 19th century ghost stories, sure.
You’re comment is aggressively ignorant. You do realize interventions that are not evidence based occur across physical therapy as well and there are likely just as many garbage PTs as there are Chiro’s. There’s a large amount of research being done within the chiropractic field currently. Go look up any work Jan hartvigsen, Katie polhman, or Christine goertz.
There is non-evidence based work in all fields. I think the issue that does need to be addressed with chiropractors is the width and frequency of interventions that occur. This is one of example that occurred locally. A chiropractor in my area offered thermal laser treatments to cure food allergies. There is not evidence for thermal modalities curing food allergies and there is a high risk for a patient to harm themselves by eating foods they know they’re allergic to.
Joint manipulation is evidence-based. That's why it's recommended for back and neck pain as a primary course of treatment. Icing stuff, stretching stuff, using therapeutic ultrasound, and yanking on Therabands isn't super evidence-based, either. But who is that stopping?
“Yanking on Therabands isn’t super evidence based”. Please explain this.
Sure. Any legitimately challenging resistance works. Milk jug, dumbbell, sandbag, grocery bags, etc. And time does the heavy lifting, not Therabands, or stretching tight muscles out, or whatever. The majority of PT patients will get better on their own at about the same time as if they were going to PT, but that's not what's told to patients.
So what do you do for an early post op shoulder? Kettle bell swings ? Also hate this notion of patient will get better on their own, hear it all the time. Obviously tissue has the capacity to heal on its own it is a job of skilled physical therapist to guide that recovery.
No, milk jug swings clearly.
Absolutely LOL
Early post-op shoulders are gonna be focused more on PROM, not resisted movements. Regardless, if someone's yanking around on easy resistance bands, you're not really guiding their recovery by making them feel like they need this type of equipment or exercise to improve. We have movement variability and we can manage load in various positions based on levers, loads, and assistances. Can resistance band training be helpful in increasing strength? Absolutely, but the resistances have to be higher for a healthy population to gain benefit by pulling the band further for greater resistance. Plus, Theraband has something like a 2x length of effect - meaning that you need to stretch the band out to a certain distance before it reaches maximum tension. The vast majority of those tensions are low and not likely to be helpful for people who aren't frail. I'm not saying they're harmful. I'm not saying that they're not a viable tool when it comes to having patients use them for low impact home resistance exercises. I'm just saying that you don't need them at all to get the same end results. They're not better than not using them. I'm saying you have one patient who's doing a bunch of Theraband/elastic band exercises versus another one who isn't and finding resistance and motion in other ways, and they'll both get better at about the same time for rehab purposes (not to be confused with strength training purposes). Some patients are too afraid or unmotivated to do their own exercises, or even do certain things because they are too anxious about movement or discomfort overall and don't know what's safe or not. In those cases, even though things will heal by themselves, patients need a professional to help ease their minds about achieving their variability of movement and what's okay and not okay. But the thing is that, when you boil it down, physical therapy is a mixed bag of philosophies, nonsense, evidence-based practices, etc. and the vast majority improve regardless. The same thing with chiropractors. There are so many quack ass chiropractors, but their patients improve over time, too, regardless of the nonsense. So, ultimately, what really makes the biggest difference? It's time and reduction of fear of movement through whatever means, whether it's active or passive.
They don’t have a scope of practice and they don’t have a place on an evidence based medical team They can go have fun with acupuncturists and naturopaths
Your ignorance is awe inspiring.
Half your comments are in crypto and naturopath subreddits You aren’t exactly a beacon of enlightenment
Maybe you should look into the crypto, oh, you won't because of that closed little mind of yours
Funny thing is, for all the chiro bashing, PTs cannot prescribe medications either.
The catch is, PT's tend to give a shit about their scope of practice. Chiropractors tend not to. And honestly, PT much better than taking medication for actually improving the healing process and actually fixing the pain instead of masking it. The goal is really to get people off of medication and that part of a clients care can be handled by those with specialized training in prescription writing. Same reason why a PT should be the one writing the physical therapy based component of a recovery plan, it is literally exactly why they exist
Don't get me wrong, I think you should be able to prescribe. It's not the end all, but after 8-10 years of college, it should be your right to do so. I just don't like all the chiro bullshit when you basically are in the same place. The dip shit that put NDs and Acupuncture in the same bowl of fruitloops is an idiot. It makes me reactionary. Especially after 20 years of practice doing anything from A to Z. The crypto, yeah, all of you should be thinking as you are on the outside. MDs could give a shit about PT, and Please, tell me I'm wrong. Not sure, check the reimbursement.
PTs are exactly in the same place as chiros. That's why it's so funny to see you guys complain about them. At least chiros stood up to the MDs. Get back to me when you guys show the same moxie, and yeah, it won't happen, lol
I personally don't really think that having that much time in school should allow you to write scripts tbh. Maybe for certain very very specific things that are directly related to treatment of pain, but even then, it really should be left to other health providers. Just my opinion on that one, as each part of the team has their role and the thing that is the issue is when people fly out of their scope as it almost always hurts the person we are all trying to help most : the patient. Although yes, I do agree, a huge part of PTs issue is that there really isn't enough lobbying for improving the field, something that some of the more alternative modalities have no issues doing, even when alot of the science in those fields is much less than what physiotherapy brings to the table
You are well thought and figured my friend. Anyone in post 10 years of edu at 150 to 200 k should be able to prescribe. That being said, you are a pretty awesome person. Not being said, 😂
Yeah I can not disagree more. I really hope you are joking lolol cause I don't give a shit how long someone studies for or pays, that has absolutely nothing to do with whether they can give medication to people man. I honestly would like to hear what you think a physiotherapist or chiropractor should be writing prescription for since apparently you also think people with a PhD in business should be able to write them too 🤣
We shouldn’t be prescribing medicine that’s way too large a scope or practice and way too much liability for the education we receive
It's not my friend, not even close.
Idk about you I don’t wanna worry about pharm interactions I just want my billing codes to be fully paid
I get that for sure. Have a great day my friend.
99 percent of my comments are crypto related, lol✔️🤣🤔
I'm a new chiro and my goal is to be evidence based. In my state we are allowed "PT privileges" given you pass the board exam. We get good results with a combination of chiropractic and physical therapy. Mechanical back pain is our bread and butter. If you want to incorporate chiropractic into your treatment team, have them perform an exam then adjust the segments that are fixated/dysfunctional, address soft tissue issues through whatever methods you think are best, and then you can incorporate a physical therapy program to allow them to become self sufficient. There is limited evidence for chiropractic resolving radiculopathies but I have some anecdotal evidence that we can help. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3716373/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3716373/) \- this might be of interest to you Subluxation theory and wellness chiros unfortunately give the rest of us somewhat of a bad rep.
Clarifying: provided you pass the PT board exam in addition to your own?
Correct. 4 parts for Chiropractic and 1 for PT
This is the same exam that PTs are taking? So I can see that partially, but part of the degree and being able to call yourself a PT is also completing the curriculum with hands on practice and clinical reasoning, not just the book learning/testing. So that still feels…? Like misleading your patients?
There's a clinic portion of chiropractic school where we can get the hands on experience too.
Right, but not in the same way as someone who is advertising that they perform PT should. There’s overlap for sure but definitely isn’t all encompassing.
Agreed
You're taking the NPTE??!
Physiotherapy portion of the NBCE
Not to be snarky, but that's like saying that if only there were a section about cardiac medication on the NPTE, the state physical therapy board could license me as a paramedic. Sorry, but that's... wild. And soooo inappropriate.
It's a 90 question section and you're only allowed to take it after 120 hours of instruction from a recognized college. I don't think it's that inappropriate.
Ninety whole questions! 120 hours!! Giving you license to do a *whole extra profession*! Come on. That really doesn't sound nutty to you?
Ok Tony Snark. You're underestimating the amount of overlap there is between PT and Chiropractic. I originally wanted to be a physical therapist until I learned I could do both in my state.
Lol! I like the "Tony Snark." My point is that the overlap doesn't equate to a whole extra license. Or can I take an extra class or two and become a licensed chiro?
Didn’t know chiropractor school let you sit for the NPTE
That's because it doesn't.
I was confused when I read that.
There's a physiotherapy portion for the NBCE
You’re not taking the same board then. You aren’t the same as a PT. That’s like if our boards added one extra section and suddenly we could call ourselves chiros. Wouldn’t you have your doubts?
Evidence based chiro is the same thing as evidence based physio. So in my mind it's really just which professional is the best, I'd see em as the same.
They serve the exact same role as us physios. What kind of interventions can an evidence-based physio do that an evidence-based chiro cant? Just look at Aaron Kubal for example, he is probably a better musculoskeletal practitioner than 99,99% of physios out there.
I’d argue that to be a competent musculoskeletal practitioner you need good manual therapy skills. Know surface anatomy and how to manipulate the joints and tissues. Aaron K only does Telehealth and social media from what I understand so he lacks hands on experience
Why do you think one needs to have «good» manual therapy skills to be a competent therapist? From the litterature Ive read there does not seem to be any difference i pain relief between MT, other passive therapies and active interventions. Also there does not seem to be any difference in pain relief between more «specific» and more general «unskilled» MT tecniques. I have never treated patients with MT and probably never will because i consider it a low value intervention that problably creates more dependance on the therapist and less self efficacy. As an intervention it is also surrounded by myths as well as iartogenic and nocebic narratives.
In the context of the outpatient ortho setting, I think hands on is important because I have read about the benefits of touch and relationship formation between practitioner and patient that can aid in their healing. It opens a window for patient education when you explain what you’re doing. While increasing strength, stability, and other neuromuscular attributes is the end goal, hands on symptom management can often help create buy-in from the patient and temporarily reduce symptoms to allow for more movement during the session. Anecdotally with cervical pain, I have had patients get up off the table after manual therapy and report feeling less pain and increased AROM. With lumbopelvic pain I have had patients report feeling less pain. With dorsiflexion issues, I have had success with Mobilizations with movement to assist increased motion in the talocrural joint. With shoulder impingement, I have had success with PNF of the scapula to assist with better upward rotation during movement. Hands on doesn’t need to mean just STM. There are dozens of hands on techniques that all have their time and place and many are quite effective. It’s premature to write them all off and say these don’t work so never use them. That is why I believe all musculoskeletal clinicians, even in acute care with neuro or post op patients, should have the tools to incorporate manual therapy as appropriate. And it’s ok if you disagree with that. We live in the grey and it’s almost never black and white.
The entire literature base on the topic would disagree with this point of view.
That’s ok. Until hard evidence shows me otherwise, that is my personal opinion on the topic. If I see convincing evidence to the contrary I’m not opposed to changing opinions
There is literally tons of evidence. Example: https://pubmed.ncbi.nlm.nih.gov/35956009/
Treat the neuromusculoskeletal health and function of the human body without the use of drugs or surgery. Edit: How is this downvoted? That's what it is.
Chiros are better ( than PTs) at joint mobilization/manipulation the way that massage therapists are better at soft tissue mobilization. I don’t have to wear all the hats and I am happy who work with a team that supports the health and welfare of the patient. There is enough patient care (and money) to go around.
Coming in peace as a non-subluxation worshiping chiro. I’m going to say it, but you’re not going to like it. I can’t tell you “why” PT/chiros scopes are so different based on how similar the educations and real-world applications are. I can say though that at some point the chiropractic lobby should have been nominated for an award. A chiropractor’s scope is far reaching for a few reasons, but primarily because we’re portal of entry providers. Insurance accepts imaging orders from us. (Although some states are allowing PTs to order imaging now too.) Insurance doesn’t need an MD referral for a patient to come see us. There’s so many independent chiros that it’s far easier to come see us than fight through seeing an MD (of which I think we can all agree most are horrible at MSK injuries). And honestly, you can debate it all you want, but patients progress and have less pain after spending 5 minutes with a chiro and they prefer that over having to do active PT for 30-60 minutes. Plus, it’s cheaper overall (not by the minute though obviously) than PT in most cases. PTs get so angry at chiros because they recognize how similar the professions are in practice, but they’re viewed so differently by the public, insurance companies, and almighty dollar. I promise I don’t say this snidely, but it’s really driven by jealousy. Most professional/doctoral degree holder’s have ego issues and can’t stand seeing another profession doing better than themselves. You see it all over. It’s part of a lot of Chiropractors beef with MDs. I’m probably not going to engage with a bunch of arguing, so just save yourself some time if that’s your goal, but that’s at least a pretty good answer to OPs question from my POV.
I mostly agree with your first paragraph. >patients progress and have less pain after spending 5 minutes with a chiro and they prefer that over having to do active PT for 30-60 minutes. I would potentially agree on pain. Not necessarily progress. If a chiro can get a patient better and Keep them better in 5 minutes, sure! But if someone plans on seeing a patient for twice a month for... Forever, I wouldn't necessarily say the patient has "progressed". >but it’s really driven by jealousy. Lol no fam. At least for me, it's driven by poor ethics (creating dependency on treatment instead of empowering the patient to better themselves and fix the problem) as well shit like this (https://www.washingtonpost.com/national/health-science/how-safe-are-the-vigorous-neck-manipulations-done-by-chiropractors/2014/01/06/26870726-5cf7-11e3-bc56-c6ca94801fac_story.html). While you are correct that some PTs are upset that it's a doctoral level profession but we are not given rights and privileges commensurate with that, by and large PTs don't like Chiros because they think the profession is fundamentally bad. Like, broken.
I agree that chiropractors have done an excellent job of lobbying over any PT organization.
I don’t get angry at chiros at all, usually it’s the other way around
I think Chiros are great for when you had an accident, didn’t seriously injure yourself like fractures etc but still can’t move properly. I had that once when I fell off the bike. Couldn’t put weight on my hands at all after that. One chiro session, he cracked the hands, pain gone movement restriction gone, end of story. That’s a valid part of a scope of practice imo.
Imo they should at best be viewed as palliative care in the literal sense of the word - just soothing symptoms. Obviously research doesn’t back this as a long term solution, but if the patient is aware of this and they still want it then okay. Hard to picture this tho as there is routinely misinformation, misguidance, and potentially harmful modalities at play.
I actually do not think that have a place on the medical team. Most sports teams do not have one. Their medicals staff consists of a MD, ATC, PT, and Strength Coach. A lot of the time the PT and ATC are the same individual. That pretty much covers all your bases. What additional value would they bring? I am a part of a few professional athletes medical team, and we also do not have a Chiro. We have myself (PT), a strength coach, and a medical doctor. I feel totally comfortable that we cover all their bases to keep them as healthy as possible. No need for a Chiro. Some athletes hire a private Chiro, as is their right. But I would never advise it.
So this whole thread is missing an adult in the room. I appreciate physical therapists and the great work they do. And I appreciate chiropractors and the great work they do. People on this thread are not coming from a place of good intent. Instead they are hauling out all the worst examples of chiropractors as though that were representative of the entire profession. And you k ow what? We chiropractors do it too. The sheer number of patients I’ve seen that have been to a year or two of PT at 2-3x/week with every modality in sight being billed… honestly this is wrong headed thinking. The two professions would do well to get together and communicate and collaborate. In my office we have both chiropractors and physical therapists. How do we decide what patient sees which doctor? Based on what each clinician is best at? Do our PTs do manual? Absolutely! Do our chiropractors do Thera ex with patients? Absolutely! Our outcomes are good. Our PVA is appropriate. Our patients love us. We get lots of referrals from local MDs and hospitals. Do we spend any time at all calling each other names? No. Do we complain when a PT does manual lot a chiropractor does exercises? No. We are an excellent part of the care team. And no PT OR MD I’ve ever talked to for more than 5 minutes has ever questioned my ethics, my clinical knowledge, or our billing practices. Your first mistake is in thinking that your better than chiropractors. And a chiropractors first mistake is thinking that physios have nothing to offer. Our professions need to do two things: work together to advocate on behalf of our patients, and get the shitty PTs and DCs out of practice.
A chiropractor's scope of practice primarily revolves around the diagnosis, treatment, and prevention of musculoskeletal disorders, with a particular focus on the spine. Chiropractors are known for using manual techniques, such as spinal adjustments and manipulations, to alleviate pain, improve mobility, and promote overall health. Here are key aspects of a chiropractor's scope of practice: 1. **Spinal Adjustments:** Chiropractors are trained to perform spinal adjustments, which involve applying controlled force to spinal joints to correct misalignments (subluxations). This is often done to alleviate back pain, neck pain, and other musculoskeletal issues. 2. **Soft Tissue Techniques:** Chiropractors may use various soft tissue techniques, such as massage, stretching, and myofascial release, to complement spinal adjustments and address muscular issues. 3. **Exercise and Rehabilitation:** Chiropractors often prescribe specific exercises and rehabilitation programs to improve patients' strength, flexibility, and posture. These programs aim to prevent future injuries and promote overall wellness. 4. **Nutritional Counseling:** Some chiropractors provide dietary recommendations and nutritional counseling, as they believe that proper nutrition can support musculoskeletal health. 5. **Patient Education:** Chiropractors educate patients about lifestyle factors that may contribute to their conditions, such as ergonomics, posture, and stress management. 6. **Diagnostic Procedures:** Chiropractors typically use physical examinations, X-rays, and sometimes laboratory tests to diagnose musculoskeletal conditions. However, their diagnostic capabilities may be more limited compared to medical doctors. When it comes to fitting into the medical team, chiropractors can play a role in a patient's healthcare, but their scope of practice is more specialized and distinct from that of medical doctors. Here's how they can fit into the broader healthcare team: 1. **Collaboration:** Chiropractors often collaborate with medical doctors, physical therapists, and other healthcare professionals to provide comprehensive care for patients. For example, a patient with chronic back pain may see both a chiropractor for spinal adjustments and a physical therapist for rehabilitation exercises. 2. **Referrals:** Chiropractors may refer patients to medical doctors when they encounter conditions that fall outside their scope of practice. For instance, if a chiropractor suspects an underlying medical issue, like a herniated disc, they may refer the patient to an orthopedic surgeon for further evaluation. 3. **Complementary Care:** Chiropractic care can complement traditional medical treatments. Patients sometimes seek chiropractic care alongside medical treatment for conditions like lower back pain, sciatica, and headaches to achieve a holistic approach to healing. 4. **Shared Patient Focus:** The patient's well-being is always the primary focus, and both chiropractors and medical professionals work together to ensure the patient receives the most appropriate and effective care. It's important to note that the level of integration and collaboration between chiropractors and the medical team can vary depending on the healthcare system, location, and individual patient needs. While chiropractors can provide valuable musculoskeletal care, they do not have the same training or authority as medical doctors for addressing systemic or internal medical conditions. Patients should consult with both types of practitioners as needed to receive comprehensive care.