Profession-Centric Behavior Hinders Our Patient Care
I read with dismay the article, "Wild West: DCs Take on PTs," in the April 15, 2013 issue.
- Since when are MDs trained in joint manipulation / adjustment? Why would they be given an exemption? I know of no medical school in the U.S. teaching this procedure.
- DOs typically have joint manipulation / adjustment coursework as an elective, so how will the California legislature ascertain the skill set of DOs in performing this procedure?
- Why should a properly trained PT be prevented from performing this procedure? If they demonstrate competence in this skill set, why shouldn't they be allowed to perform it?
How hypocritical of the California Chiropractic Association! Haven't they been watching the situation in Texas, in which the Texas Medical Association wants to prevent DCs in Texas from having the ability to perform diagnosis, claiming the sole right to this procedure? This type of profession-centric behavior on both sides only hinders rendering quality patient care.
The future of health care will be about defining skill sets, then choosing the most effective and efficient practitioner to provide that skill set. [See Murphy D, et al. The establishment of a primary spine practitioner and its benefits to health care reform in the United States. Chiropractic and Manual Therapies, 2011;19(17).] It will no longer be about what your degree is, but about your ability to provide evidence-based, patient-centered care.
John M. Ventura, DC, DABCO
We Are the Most Overtrained Profession in the Country
The pre-chiropractic requirements when I matriculated at Logan in 1980 were two years of college (with specific classes and labs included). Since that time, the entrance requirements to chiropractic school have gone up considerably, with most students having a bachelor's degree at the time of entrance. The classwork, at least for the first two years, is intense, with students carrying anywhere from 20 to 30 hours a semester.
Overall, the classwork and clinical time is between four and five years of postgraduate study. Add to that the national and state board examinations, and I think the chiropractors coming out of school today are very well-educated.
Once in practice, we are allowed to diagnose, order X-rays and advanced imaging studies, lab work were necessary, diet advice and adjust people (plus PT and acupuncture). That's it. It seems like we are the most overtrained profession in the country for what we are allowed to do.
We are on the brink of a great opportunity thanks to Obamacare generating a nationwide lack of PCPs. Every article I have read about filling this void talks about nurse practitioners and PAs stepping up to fill the gap – and they are quite willing to do so. Chiropractors are never mentioned. Why? Because our self-limiting decision as a profession to shun all medications, even a limited schedule of drugs, keeps us from even being considered for this great opportunity to become integrated into and privy to the referral circles the medical profession keeps close to its chest.
As it is now, when one of my patients needs some routine medication, I have to refer them to another doctor, unnecessarily increasing the patient's health care costs and inconveniencing them; plus running the risk that they may get lost in the process. I see this as a historic opportunity to step up and introduce so many more people to the benefits of chiropractic.
Even if a particular chiropractor chooses not to prescribe any medication at all, the benefits of being included as another doctor in the dominant system of health care will give us access to many more patients who will benefit from chiropractic. Isn't what this is all about? Introducing more people to chiropractic and getting as many people well as possible?
Tim Levin, DC
Dynamic Chiropractic encourages letters to the editor to discuss issues relevant to the profession and/or to respond to a previously published article. Submission is acknowledgment that your letter may be published in a future issue of the publication. Submit your letter to ; include your full name, relevant degree(s) obtained, as well as the city and state in which you practice.