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View Full Version : What to do if you can't get into a US Med School or Osteopat



azskeptic
01-09-2004, 12:56 PM
Many people coming to a forum like this have been beaten up in the process of trying to get into medical schools in the US. If they have tried the osteopathic school route and also failed to get in they are good candidates for offshore schools (the Osteopathic schools can be difficult to get into also).

Some people look at the US govt. websites and they recommend alternative professions like chiropractic,nursing,etc.
I have always wondered why people go to chiropractic
school,in light of the massive information available
showing it as a hard way to make a living. In addition
you are facing a life of frustration in that your
scope of practice won't allow you to do alot of what
is needed to help your patient i.e. you can't give
shots,you can't do surgery, you can't admit to a
hospital. You end up as a second rate citizen, even
when you are a nice person who has tried to gain
education in the healing process.

If you have a low MCAT or grad point average, even carib. schools are becoming harder for people to get admitted to. The schools are
trying to take the best students they can i.e. best
student meaning they test well but not necessarily are
better care providers. If you aren't a person who
scores 25-30 on your MCATS you are facing trouble in the US though some still get admitted if they have unique backgrounds or stories. You need sometimes to get some help packaging yourself.

So what do you do? go to a
reputable offshore school. The top 3 (the Harvards of
the Carib.

http://www.aucmed.edu/

http://www.rossmed.edu/

http://www.sgu.edu/

If you can't get in there, you go to the second range
schools:

http://www.saba.edu/

http://www.stmatthews.edu/

http://www.stjamesmed.com/

http://www.gdl.uag.mx/medicine/default.html

If you get turned down there,it may be that you aren't going to become an MD. Don't waste your money with internet based medical schools or those located in fleabag locations--visit the school, consult state medical boards to see how they are regarded. If you can't get in to carib schools, then go to a
physicians assistant school or nurse practicioner,etc.
training that will allow you to help people and get
paid a decent salary. Some people go back to school and show they can make the grades and then get into medical school.

There are other alternative medical schools (the hybrid African recognized/England located schools St. Chris and Kigezi which have few grads yet and may have WHO approval problems in the future), the E. Europe schools and these are all additional alternatives if you still have fire in your belly to go to med school after having been turned down everywhere else.

ValueMd is a great place to hear from students their experiences and even interact with State Board employees. It is all part of the education process.

Beaker
01-09-2004, 01:56 PM
whats this, a relatively postive post from azskeptic that actually contains some guidance and alternatives rather than his typical skeptism. i'm very impressed. keep it up!

i'm gonna play devils advocate here for the sake of debate, but i dont necessarily agree with everything i'm presenting here.

first of all, sgu, auc and ross r commonly referred to as the "big 3" and not the "top 3" like u wrote. the name came about coz of their "big" class sizes. they might also be the "top 3" choices for many, but that is based on opinions which have not be been universally accepted, like the term "big 3".

also, i've only heard ppl refer to sgu as the "harvard of the carib". but to say all of the big 3 r the "harvards of the carib" is also a new concept ur presenting again and therefore not widelly accepted. but if this was simply ur own opinions, sorry for misunderstanding.

still playing the devils advocate, i'll disagree with ur assessment of chiropractors.


Some people look at the US govt. websites and they recommend alternative professions like chiropractic,nursing,etc.
I have always wondered why people go to chiropractic
school,in light of the massive information available
showing it as a hard way to make a living. In addition
you are facing a life of frustration in that your
scope of practice won't allow you to do alot of what
is needed to help your patient i.e. you can't give
shots,you can't do surgery, you can't admit to a
hospital. You end up as a second rate citizen, even
when you are a nice person who has tried to gain
education in the healing process.


in the medical field, the medical team works together to help the pts, but we all have different roles. some give shots, do surgery, admit to hospitals, etc while others do other things which some can argue is no less important (nurses, lab techs, etc.)

but it might help u to think of chiros as specialists who only deal with one thing, adjusting the spinal cord. unless ur a d.o., a physician doesnt do this. instead they will try to provide relief through means like giving shots, doing surgery, or admitting to the hospital. in the same way that an m.d. wont adjust a spine (or a phsychiatrist wont do surgery), chiros will not do the things u mentioned.

r u also saying that specializing in one field of medicine is not recommended coz u wont be able to do things that other specialists can do? in those cases, u would refer to a specialist who can do them. well the same argument can be made for chiros who can adjust adjust backs, but will stay clear of other things.

enuf with the devils advocate stuff. my own personal view is that some (not all) chiros r quacks. particularly the ones who tell u they can cure cancer by adjusting ur back (along with lifetime adjustments for a price). but i can also say that some chiros provide some pain relief that can not always be provided by an m.d., which shows they can be a useful part of health care in certain situations.

but theres now a new hybrid of the 2 professions with a title of d.o. theyre trained in spinal manipulations similar to chiros as well as the things u mentioned about the m.d. but only a very, very small percent of d.o. actually perform manipulations, so they r really no different than an m.d. in the real world.

my point is that a medical team is made up of alot more than just the ppl who give shots, do surgery, or admit pts to hospitals. an m.d. would be very limited and largely unsuccessful without the many others who contribute to pt care. there should be no shame in wanting to help others without being a physician. but dont claim to cure cancer from it either :lol:

peace

stephew
01-09-2004, 02:12 PM
beaker actually, whether or not you happen to agree with assessment, the "big three" was a not a ref to class size but indeed the sence that they were the "top" schools to choose from. But its not a designation like "Ivy league". Ie it means nothing.

but to be honest arguing this or the harvard of the carib really is nit picking if you ask me. Sgu students would sardonically call themselves both the harvard of the caribbean, but equally, the "cream of the crap".

Please guys, keep this in context; its not a comment on the quality of anything, only the facts regarding the monkiers that have come along over the years amongst students.

azskeptic
01-09-2004, 02:19 PM
my theory is that the field of chiropractics is so rampant with fraud and quackery that the good folks get lost in the chase. Some of my friends who are DC's are extremely good at listening to patients,etc. but their tools are limited...they can work well on lower back but they can't do much else scientifically. When you get through med school you'll see most MD's and DO's have little to do with chiropractors since they see the quacks mostly...you know the types, the ones who try to get patients hooked on chiropractic for life (they go to workshops that teach them that). They sell vitamins for a wide range of things that have no scientific base.

Reference 'top' 'Harvard' I guess I am distiguishing them as having the most intrastructure. Beaker, go through my posts and you'll find more positive than negative...just may be that my negatives trip your trigger because they are apart issues that you disagree.

az skeptic

Beaker
01-09-2004, 02:51 PM
beaker actually, whether or not you happen to agree with assessment, the "big three" was a not a ref to class size but indeed the sence that they were the "top" schools to choose from. But its not a designation like "Ivy league". Ie it means nothing.

its just the opposite. i agree with the assessment that these r the top 3 choices for many which is proven by their larger enrollment numbers. but i disagree that the ppl who use the term "big 3" r in agreement that these r the universally accepted "top 3" rather than the "big 3". if they thought that ppl would make that misinterpretation, i doubt they would use it in sentences like "i chose my school over the 'big 3' coz...". how can they choose something over their top choices?

the big 3 r the largest (most students and grads), been around the longest, r the best known (different than 'known to be the best'), etc. there is not an undisputed concensus saying theyre the best 3 to choose from for everyone, but i do agree that theyre the best choices for many ppl. but many others have different priorities (costs, time, class size, location, etc) who will choose other places over the big 3. even though not everyone will place them collectively as their "top" choices, it is an undisputed fact that sgu, ross and auc r the biggest and therefore have all of the associated pros and cons associated with that classification, hence the appropriate term the "big 3". but please dont mistake that to mean that theyre the "top 3", whether or not u would agree with that assessment.


the "cream of the crap".

i just love that one :lol: hope u dont mind if i use it

Beaker
01-09-2004, 03:08 PM
Beaker, go through my posts and you'll find more positive than negative...just may be that my negatives trip your trigger because they are apart issues that you disagree.

az skeptic

c'mon azskepic, its all in ur name, u present a mostly skeptical view of things. nothing wrong with that as long as u have good intentions (i think u do) and as long as u provide alternatives, which u did in this last post.

its kinda like pos and neg reinforcement. theyre both meant to accomplish the same thing, but in different ways and with different effectiveness.

using ur posts, by telling someone that what theyre doing is no good, u have given them nothing to choose to correct their "bad choice", and this can only lead to a discouraging message. but if u tell them that the bad choice can be fixed by doing something else, u have given them hope and encouagement.

i'm sure i'm not the first to see this in ur posts. maybe i should have used the words "encouraging" and "discouraging" instead of "pos" and "neg", but thats what i meant. so it has nothing to do with my agreement or disagreement with ur message. instead its based on providing information which can be used to better the person's situation rather than simply pointing out how bad their choices have been. but no offense intended :wink:

TaxiDriver
01-09-2004, 03:22 PM
If someone wants to come back to the US to practice, then SGU, Ross and AUC should be heavily looked at. I agree these could be referred to as the top 3, whether in # of ppl going or quality. There should be very few reasons why you should pick another school instead of these 3. Being established, having a long history, many practicing grads and some familarity with residency directors are important.

The "big" name comes from the notion that these are the best schools you should go to if you want to come back the US quickly. Why would you go to a school with a 20% Step 1 pass rate instead? Why would you go to a school that keeps its graduates and clinicals a secret instead?

azskeptic
01-09-2004, 03:26 PM
Beaker, go through my posts and you'll find more positive than negative...just may be that my negatives trip your trigger because they are apart issues that you disagree.

az skeptic

c'mon azskepic, its all in ur name, u present a mostly skeptical view of things. nothing wrong with that as long as u have good intentions (i think u do) and as long as u provide alternatives, which u did in this last post.

its kinda like pos and neg reinforcement. theyre both meant to accomplish the same thing, but in different ways and with different effectiveness.

using ur posts, by telling someone that what theyre doing is no good, u have given them nothing to choose to correct their "bad choice", and this can only lead to a discouraging message. but if u tell them that the bad choice can be fixed by doing something else, u have given them hope and encouagement.

i'm sure i'm not the first to see this in ur posts. maybe i should have used the words "encouraging" and "discouraging" instead of "pos" and "neg", but thats what i meant. so it has nothing to do with my agreement or disagreement with ur message. instead its based on providing information which can be used to better the person's situation rather than simply pointing out how bad their choices have been. but no offense intended :wink:

Ok, let's change my screen name......got any ideas?

Beaker
01-09-2004, 03:47 PM
If someone wants to come back to the US to practice, then SGU, Ross and AUC should be heavily looked at. I agree these could be referred to as the top 3, whether in # of ppl going or quality. There should be very few reasons why you should pick another school instead of these 3. Being established, having a long history, many practicing grads and some familarity with residency directors are important.

The "big" name comes from the notion that these are the best schools you should go to if you want to come back the US quickly. Why would you go to a school with a 20% Step 1 pass rate instead? Why would you go to a school that keeps its graduates and clinicals a secret instead?

ur mixing up the terms. i'm not saying that sgu, ross and auc are or are not the top 3 schools in the carib. i'm saying that the term that is widely used, "big 3", refers to the relative size, history, rep, etc. rather than the quality. that doesnt mean that they arent the "top" quality, it just means that the term "big" has been meant to describe quantity and not quality. in addition to being the biggest, some (not all) also consider them to be the best. but please dont confuse the terms to mean the same thing is all i'm saying.

ur other points about choosing one school over another have nothing to do with the term "big" vs "top", so i wont attempt to answer them since theyre unrelated to the topic.

dsfx
01-09-2004, 04:04 PM
AZSKEPTIC, why the ongoing chiropratic bashing?

azskeptic
01-09-2004, 04:12 PM
AZSKEPTIC, why the ongoing chiropratic bashing?

I am bashing the quacks..not the good chiropractors. The problems are that those who believe in non-scientific chiropractic stuff (Life University is a good example) hurt those who try and do scientific treatment of patients.

There are good chiropractors who practice within the scope of things that they can replicate results i.e. lower back......if I had lower back problems I would go to one of them. az skeptic p.s. by the way, MD's who practice unscientific medicine i.e. woo woo I also feel are a danger and embarrasment to the helping profession.

stephew
01-09-2004, 04:14 PM
lets at least make a facimile of an attempt to stay on topic and not batter each other- if you have a personal grip with someone please consider trying to clear it up via PM.

AS for cream of the crap, be my guest; I didn't coin it.
steph

TaxiDriver
01-09-2004, 04:49 PM
If someone wants to come back to the US to practice, then SGU, Ross and AUC should be heavily looked at. I agree these could be referred to as the top 3, whether in # of ppl going or quality. There should be very few reasons why you should pick another school instead of these 3. Being established, having a long history, many practicing grads and some familarity with residency directors are important.

The "big" name comes from the notion that these are the best schools you should go to if you want to come back the US quickly. Why would you go to a school with a 20% Step 1 pass rate instead? Why would you go to a school that keeps its graduates and clinicals a secret instead?

ur other points about choosing one school over another have nothing to do with the term "big" vs "top", so i wont attempt to answer them since theyre unrelated to the topic.

No, but they sure are related to the original post.

azskeptic
01-09-2004, 05:13 PM
If someone wants to come back to the US to practice, then SGU, Ross and AUC should be heavily looked at. I agree these could be referred to as the top 3, whether in # of ppl going or quality. There should be very few reasons why you should pick another school instead of these 3. Being established, having a long history, many practicing grads and some familarity with residency directors are important.

The "big" name comes from the notion that these are the best schools you should go to if you want to come back the US quickly. Why would you go to a school with a 20% Step 1 pass rate instead? Why would you go to a school that keeps its graduates and clinicals a secret instead?

ur other points about choosing one school over another have nothing to do with the term "big" vs "top", so i wont attempt to answer them since theyre unrelated to the topic.

No, but they sure are related to the original post.

I stand by my statement....based on intrastructure and success rates of their graduates you can call them the top 3.....az skeptic

prsch132
01-09-2004, 10:12 PM
AZSKEPTIC...
I do not really agree with everything you say about chiropractic. I do agree that there are MANY that spoil our reputation. The scope is not as limited as you think, in fact we provide many scientific/physiological answers that MDs cannot answer when evaluating a muscular or skeletal disorder. Sure, you can go to a MD and get pain meds, steroid shots, or MRIs. What is you answer to your patient then, when they ask "how long need I be on this medication until it fixes my problem?" ...The answer is forever, which seems crazy. The pain did not start from a lack of meds, most pains are easy to explain. I know there are studies that only show chiropractic is good for LBP, but can't you also see that Low Back involvment and irritation causes radicular symptoms. Well, the same thing happens in the neck and mid-back...and even within the soft tissues of the limbs. Start asking people that slump down in their chair and carry their head front of their body how often they get headaches, and shoulder pain. Ask if their hands are ever numb or tingle. Chiros can manipulate AND perform rahab to restore these things. It just seemed to me that you believe that chiropractors can only help the low back and just adjust, adjust, and adjust. That is like saying an MD can only perscribe, prescribe, and prescribe. Their practice would be limited in that case. As for the success of chiros....They may seem less successful because they do have to start up their own clinic, they cannot just walk into a hospital and work (Well, I guess Truman Medical Center in Kansas City has chiros on staff now). Chiropractic schools are also very high in tuition, because they are all private right now. Also.....there are alot of wierd people that graduate. They don't choose chiro school because they did not get into med school. People that gravitate to "the natural way" (hippies, ect) tend to go to chiropractic school because that is more how they think. They are weird all together. I wish I could show you my point of view on chiropractic. We treat people with respect and are considered a doctor in the health care system. My mom is a RN, my sister is a Medical Doctor, and there are 15 chriopractors in my family (all fathers and sons). All the chiropractors in my family make between $500-700k each....it doesn't seem rough to me....just another view.

azskeptic
01-09-2004, 10:32 PM
AZSKEPTIC...
I do not really agree with everything you say about chiropractic. I do agree that there are MANY that spoil our reputation. The scope is not as limited as you think, in fact we provide many scientific/physiological answers that MDs cannot answer when evaluating a muscular or skeletal disorder. Sure, you can go to a MD and get pain meds, steroid shots, or MRIs. What is you answer to your patient then, when they ask "how long need I be on this medication until it fixes my problem?" ...The answer is forever, which seems crazy. The pain did not start from a lack of meds, most pains are easy to explain. I know there are studies that only show chiropractic is good for LBP, but can't you also see that Low Back involvment and irritation causes radicular symptoms. Well, the same thing happens in the neck and mid-back...and even within the soft tissues of the limbs. Start asking people that slump down in their chair and carry their head front of their body how often they get headaches, and shoulder pain. Ask if their hands are ever numb or tingle. Chiros can manipulate AND perform rahab to restore these things. It just seemed to me that you believe that chiropractors can only help the low back and just adjust, adjust, and adjust. That is like saying an MD can only perscribe, prescribe, and prescribe. Their practice would be limited in that case. As for the success of chiros....They may seem less successful because they do have to start up their own clinic, they cannot just walk into a hospital and work (Well, I guess Truman Medical Center in Kansas City has chiros on staff now). Chiropractic schools are also very high in tuition, because they are all private right now. Also.....there are alot of wierd people that graduate. They don't choose chiro school because they did not get into med school. People that gravitate to "the natural way" (hippies, ect) tend to go to chiropractic school because that is more how they think. They are weird all together. I wish I could show you my point of view on chiropractic. We treat people with respect and are considered a doctor in the health care system. My mom is a RN, my sister is a Medical Doctor, and there are 15 chriopractors in my family (all fathers and sons). All the chiropractors in my family make between $500-700k each....it doesn't seem rough to me....just another view.

There are no DC's on staff of the hospital..read the press release..they are renting space for a clinic there

http://www.clevelandchiropractic.edu/News/09_02_release.htm

There are many good chiropractors...unfortunately you are limited in what you can do,under your scope of practice if you are doing evidence based medicine....

with that said and done,are you going to join the family business or become an MD? If so why?

prsch132
01-09-2004, 11:01 PM
I am a DC. I thought of going to medical school. But, there is not any advantage from MY standpoint. My family is already well known and respected in the state. The medical doctors in my sisters medical school interviews knew who she was by her last name, and they were in a different state (good? or bad?). I guess a few of the main reason are that I wouldn't have to get me hands dirty, it is very laid-back, and not many patients would die under my care (because of the conditons I would treat). LBP is a major issue in the USA. It means alot when a person is having a rough time in their life because of heaaches, or a person cannot work because of LBP. I want to be focused on quality of life and prevention. I know that people "keep coming back all the time" to chiros. It seems strange if it is taken in the wrong context. I will always see the same dentist and eye doctor as long as they live and as long as I have a disorder that needs to be prevented or on a regular check-up. With the spine, and adjustment is not like moving blocks of wood around. I would not be telling the truth to a patient if I said I "popped that back into place". It is certain that you would see little to no change on a post-adjustment radiograph. It is actually a process of rehabiltation where the ligaments are stressed through manipulation and stretching of ligaments, or stablizing them and strengthening muscle groups. I will see a patient on a very agressive treatment plan for a couple months. I will admit that a patient will usually feel relief after a treatment, but it takes work to make a true structural change....through maniplulation, physical theraphy, and lifestyle modifications. If you don't follow through on a treatment plan with a patient, they WILL come back in 3-6 months with the same symptoms and they WILL be a rollercoaster patient forever. If you do have any questions as to why or what with chiropractic, I will give you an honest (and scientific) opinion. I saw your site you are making.

neilc
01-09-2004, 11:05 PM
well, i worked with a chiro when i was just out of high school, and my old landlord was a chiro. i also played hockey with one, and he was a decent friend of mine. that being said, as a physician i would RARELY IF EVER refer a patient to a chiro. my evidence is purely anecdotal, but each of these folks that i knew on a freindly basis had many of the same characteristics that i will forever associate with chiropractic.
1. they did not practice evidence based medicene. they simply wanted every person that came in the door to come back several times a week as long as possible.
2. the primary goal of the practice was to recruit patients, regardless of need.
3. they consistently badmouthed established and proven beneficial medical practices (vaccinations, antibiotics, surgeries, etc...) while offering no reasonable alternative.
4. they accused MD's of simply prescribing drugs to make money (ridiculous, as the pharmacist makes the money off an Rx) while pushing hard unproven dietary supplements and naturopathic compounds (which they sold and DID profit off) that were not adequately studied nor neccesarily indicated for what the patients complaints were. i personally saw things that we were overstocked in being pushed on every patient seen in a day...

anyhow, i am sure there are good DC's out there. whether i consider them "doctors" is questionable, as they don't seem to meet the training requirements (limited post-grad work, BA not required, etc...). in some cases, i may consider them as part of the health care team, but i feel that licensed PT's can offer many of the same services, based on science that i trust. so, i just don't see them as a big part of my health care team.

i would like to see chiropractic grow, become more evidence based and shed the tainted image that they currently have in the field of medicine. however, there are quite a few crackpots out there that thrive on being on the fringe of established medicine, and this is actually what brings patients to them. it seems to me that the profession has damaged itself, and that it will be a long time coming before they can rid themselves of the monkey that they placed on their own back.

prsch132
01-09-2004, 11:24 PM
"1. they did not practice evidence based medicene"

-You need to do some more research on that...the government even has studies on its effectiveness"

"the primary goal of the practice was to recruit patients, regardless of need"

-Every doctor wants to help as many people as possible. What? You don't? When I hear an MD say this over and over, it sounds like they are scared of loosing their own patients. Just like when dentistry and podiatry specialized. I can see a bias when medical doctors and hosptials say this. LBP gets them paid for an office visit, an MRI, other special testing, and expensive physical therapy work.

"they consistently badmouthed established and proven beneficial medical practices"

-Isn't that what you are doing to chiropractic right now?

" limited post-grad work, BA not required"

-Anyone can do Post-grad work. Who cares. BTW...Just as many states require a DC to have an undergraduate degree than they do for MDs. Not all states require a degree to practice medicine. That is a misconception.

"i feel that licensed PT's can offer many of the same services"

-In my state, PTs are not licenced healthcare practitioners. They have no referral power. They cannot see a patient without a refferral from and MD or DC. They cannot draw blood, diagnose, read x-rays, take-xrays. Basically, all they can do is stretch a patient or have them exercise. They have no exlusive legal rights.

"whether i consider them "doctors" is questionable"

-Whether i consider you "personable" is questionale.

neilc
01-09-2004, 11:40 PM
"1. they did not practice evidence based medicene"

-You need to do some more research on that...the government even has studies on its effectiveness"

"the primary goal of the practice was to recruit patients, regardless of need"

-Every doctor wants to help as many people as possible. What? You don't? When I hear an MD say this over and over, it sounds like they are scared of loosing their own patients. Just like when dentistry and podiatry specialized. I can see a bias when medical doctors and hosptials say this. LBP gets them paid for an office visit, an MRI, other special testing, and expensive physical therapy work.

"they consistently badmouthed established and proven beneficial medical practices"

-Isn't that what you are doing to chiropractic right now?

" limited post-grad work, BA not required"

-Anyone can do Post-grad work. Who cares. BTW...Just as many states require a DC to have an undergraduate degree than they do for MDs. Not all states require a degree to practice medicine. That is a misconception.

"i feel that licensed PT's can offer many of the same services"

-In my state, PTs are not licenced healthcare practitioners. They have no referral power. They cannot see a patient without a refferral from and MD or DC. They cannot draw blood, diagnose, read x-rays, take-xrays. Basically, all they can do is stretch a patient or have them exercise. They have no exlusive legal rights.

"whether i consider them "doctors" is questionable"

-Whether i consider you "personable" is questionale.

interesting....well, my rebuttal...

1. there have been studies done which show the benefits of chiropractic in cases of low back pain of musculoskeletal orgin. i am sure there are some other studies out there that show some other musculoskeletal benefits of chiro. however, i have yet to see chiro proven as helpful for allergies, prevention of systemic illness, asthma, etc...all of these claims were made by each of the chiros i work with.

2. i don't know too many MD's that are asking patients to come back three times a week for preventive care. sure, docs like to have patients. but, in all my experience in allopathic medicine, folks tend to come to the doctor when they have a clear need, and require treatment. i have never seen an MD in the mall recruiting patients.

3. i am not bad-mouthing established and proven medical practice, i am questioning the practices of the few chiros that i knew, and the observing that they did not follow established and proven medical practice, in fact bad mouthed it.

4. in my state PT's are licensed, and i would trust the education of a PT. they are able to evaluate and rehab patients that are refered to them by MD's, which is exactly what they are supposed to do. they offer excellent rehab programs for many patients suffering from musculoskeletal pain and disfunction, patients rehabing from surgery and orthopedic/sports injuries, they take care of burn patients and provide wound care, etc...i have worked in PT also, and have never seen them recomend unstudied supplements, have never seen them retain a healthy patient for financial purposes, etc. in short, i trust them, something that the chiros i have worked with have not earned from me.

5. i am aware that an undergrad degree is not required to practice medicine, but a minimum requirement of med school is 90 units, with some science requirements. as i understand it, you can attend some DC schools for 4 years without undergrad requirements and graduate to become a "doctor". in addition, to practice medicine you must participate in a accredited post-graduate training program of at least one year, which involves lots of supervised, direct patient care.

6. i don't mind at all if you do not find me personable. many people do, some don't, such is life. however, that has nothing to do with the discussion.

prsch132
01-09-2004, 11:54 PM
I do agree with your points. I think mall screenings, ect are horrid. I would never give supplements out like you mentioned. That is crazy! I would only see a patient a 3 times per week if they were acute (or asymptomatic with structural deformities....such as scolisosis or reverse cervical curve). Can you imagine if a patient had to go the the office everytime they swallowed a pill.....they have to come in to be treated in our case. I do know of med schools that don't require a degree to get in. That is up to the system. I am going to push Cleveland Chiro College to change their policy on that.....I've got them to bann AK, Muscle Testing, ect. I think that it is insane to treat a pt for asthma, allergies, ect. However, It is neat when they happen to improve under your care. That should never be a primary objective. I understand your thing with PTs. In my state, they work for both of us when needed and refferd to.

neilc
01-10-2004, 12:07 AM
it is good to see that you have an open mind to the negatives, and are working for change.

if chiropractic limited itself to practicing based on evidence, if the profession was more active in producing research and studies documenting efficacy, i would be all for it. if the profession was able to rid itself of all the folks out there practicing on the fringe, it would be great for the many legit DC's out there. unfortunately, my experience with chiropractic has lead me to veiw its practioners with a skeptical eye. it is unfortunate, but i have had some negative experience.

in the future, given a well defined, evidence based scope of practice, i would certainly consider DC's a valued part of the health care team. i hope this happens. but, for now, i am much more comfortable with PT's training, and what they can do for patients. unfortunately, this is also the perception of nearly every MD that i work with.

so, chiro has a way to go, in my humble opinion. it sounds like you are dedicated to the profession, and i admire that you aim to raise the bar for both schools and the practice of chiropractic. i wish you luck in your endeavors, and i do agree that well studied modalities of chiropractic that benefit my patients should be utilized, and when i am comfortable with the process and results, and when i am convinced my patients will benefit, i should send my patients to a DC.

azskeptic
01-10-2004, 07:54 AM
I do agree with your points. I think mall screenings, ect are horrid. I would never give supplements out like you mentioned. That is crazy! I would only see a patient a 3 times per week if they were acute (or asymptomatic with structural deformities....such as scolisosis or reverse cervical curve). Can you imagine if a patient had to go the the office everytime they swallowed a pill.....they have to come in to be treated in our case. I do know of med schools that don't require a degree to get in. That is up to the system. I am going to push Cleveland Chiro College to change their policy on that.....I've got them to bann AK, Muscle Testing, ect. I think that it is insane to treat a pt for asthma, allergies, ect. However, It is neat when they happen to improve under your care. That should never be a primary objective. I understand your thing with PTs. In my state, they work for both of us when needed and refferd to.

Do you believe in vaccinations? Many chiropractors do not.

prsch132
01-10-2004, 01:21 PM
Yes and no. In my family, 2 children died after they were vaccinated for pertusis. Well, our MD said my younger sisters should not get it. Well, they ended up getting pertusis when they were 6. It was 2 months of coughing and vomiting. I could see how it could effect an infant or a region of poverty. In 1986 in kansas, there were 1,300 cases of pertusis. That seems high. What is even more strange is that over 2/3 of the people that had pertusis were fully vaccinated for it. I would surely be vaccinated if there were a deadly outbreak of a VIRUS in our country. For the little things, like chicken pox, ect....seems crazy. When I was little, I was forced to play with friends when they got the pox so I could get it and get it over with. Now, they want to give a pox vaccine. Well, if the vaccine is effective, it is likely that it is only good for 15 to 20 years. You now have an adult that can get the pox virus and, that becomes a problem for the adult. So, to sum it up....I would reconmend vaccination, depending on the circumstance. Everyone has to make a personal stance to it. I am vaccinated so far. It is probable that I never will be again, unless there is an out break (no, west nile is not something to worry about, polio or small pox-yes). I have relatives that have never been vaccinated or had an antibiotic their entire life. They have gotten by fine.

heart1st
01-10-2004, 07:07 PM
someone described osteopathy as a new thing.
It is not.
I was delivered by a D.O., nearly 54 years ago.
It was started by Andrew Taylor, an M.D. in the
late 1800s.
Daniel ***** Palmer founded chiropractic in this
country a bit later than Taylor founded osteopathy.

The D.O. who delivered me, Dr. Richard Eby, founded
the College of Osteopathic Medicine of the Pacific,
now known as the Western University of Health Sciences,
after adding PA, Pharm and PT programs (among others,
I'm sure.)

azskeptic
01-10-2004, 07:20 PM
someone described osteopathy as a new thing.
It is not.
I was delivered by a D.O., nearly 54 years ago.
It was started by Andrew Taylor, an M.D. in the
late 1800s.
Daniel ***** Palmer founded chiropractic in this
country a bit later than Taylor founded osteopathy.

The D.O. who delivered me, Dr. Richard Eby, founded
the College of Osteopathic Medicine of the Pacific,
now known as the Western University of Health Sciences,
after adding PA, Pharm and PT programs (among others,
I'm sure.)

In the midwest (Mo/Ks/etc.) DO's are the family practice folks for many people. My doctor when I was an adolescent,Dr. Hand, was an amazing doctor....when I was 7 my mother worked at the Osteopathic College in KC and had a heart attack...he took care of her for free and organized all of the doctors to put money together so she was paid like she was still working so that my family could survive....he was a doctor's doctor...and I think of him often..DO's are good doctors....their knowledge of the body is like an engineers knowledge of the bridges...if you have pain they can do amazing things for you,in addition to meds and surgery.

az skeptic

AUCMD2006
01-10-2004, 09:51 PM
it just seems like the old guard is refusing to let your profession evolve and is holding on to that sublexation and cure all crap. medicine at the turn of the century was barbaric and the last person you ever wanted to see was a surgeon yet as new thinsg developed we let go of blood letting and adopted aseptic techinique.

chiros have their place and can play an integral part of patient care specially since insurance will not pay a DO to do manipulation but will pay a chiro but it is an issue of keeping the education scientific based and stoping this life university cult indoctrination.

what bothers me is seeing MD's and DO's lending their titles to infomercials lately, they should be disbarred, wait that's lawyers..hehe that should not be allowed under any circumstances we are lowering the standards of the profession as soon as a Dr starts pushing miracle pimple cream we start losing credibility. Then it will be like those vitamin commercials when they interview Dr jones and at the credits it reveaqled that he's a DC and all of a sudden the vitamins don't seem important anymore. the over commerciaization coupled with your "hippies" has done a lot of harm to your profession and a diservice to patients who could really benefit from it . i had a patient refuse chiro referraal b/c he was diagnosed in the mini mall and didn't trust them. he went to a neurosurgeon and was in rehad for six months

azskeptic
01-10-2004, 10:01 PM
it just seems like the old guard is refusing to let your profession evolve and is holding on to that sublexation and cure all crap. medicine at the turn of the century was barbaric and the last person you ever wanted to see was a surgeon yet as new thinsg developed we let go of blood letting and adopted aseptic techinique.

chiros have their place and can play an integral part of patient care specially since insurance will not pay a DO to do manipulation but will pay a chiro but it is an issue of keeping the education scientific based and stoping this life university cult indoctrination.

what bothers me is seeing MD's and DO's lending their titles to infomercials lately, they should be disbarred, wait that's lawyers..hehe that should not be allowed under any circumstances we are lowering the standards of the profession as soon as a Dr starts pushing miracle pimple cream we start losing credibility. Then it will be like those vitamin commercials when they interview Dr jones and at the credits it reveaqled that he's a DC and all of a sudden the vitamins don't seem important anymore. the over commerciaization coupled with your "hippies" has done a lot of harm to your profession and a diservice to patients who could really benefit from it . i had a patient refuse chiro referraal b/c he was diagnosed in the mini mall and didn't trust them. he went to a neurosurgeon and was in rehad for six months

It is not only the old guard...slowly but surely I am realizing that some people who go into chiropractic medicine are people who couldn't pass the exams for MD's anyway...so you basically have people who are struggling helping people who have problems...an example..anyone who believes in the fairy tales that are taught by those who believe in Dr. Palmers work are not in touch with reality......many people who become DC's want to help people and embrace the whole weird thing that sublaxations are the root of all problems...even though 2 DC's can't read the same xrays the same and show the problem.....Teratos has a great saying on his signature..something about Medicine is entertaining patients until they get well themselves...that is what much of chiropractic appears to be because the treatments can't be doing it.......

If you want to read some choice stuff read Dr. Sid Williams of Life University (no longer the president)'s stuff.....basically crack the back and heal what ails you.....

with that said, there are chiropractors who do good stuff for backs...seen it myself....

az skeptic...not anti-chiropractic...anti quackery though

prsch132
01-11-2004, 12:41 AM
Actually, chiropractic was founded 109 years ago, in 1895 by DD Palmer. I do agree with you AZSKEPT....Palmers have really screwed the system. They have their BJ Bibles, are completely straight, they form the ICA and break our proffession into 2 parties, and they also prevented the the Medical School of Florida State from having the chiropractic students in their classes until the clinical portion. I agree with you all, and I am a DC. It is true that many chiros get different listings when reading x-rays. It is stupid. However, it is dumb to say that thrusting at someones T5 level is just going to move T5. It doesn't move anything. It stretches the ligaments at the T5 region. So, if you have a right-handed curve at the T5 level, you thrust at the APEX of the curve back to the left. You also want the pt to do right lateral bending exercices, change posture, and undergo therapy for the muscle spasm, myalgia, ect. So, a T5 listing is not going to be that different if treated like T4 or T6, which another doctor treats as a different listing. Furthermore, the radiograph is used to rule out cancers, DJD, arthrotides, vascular disorders (AAA), and other things that mimic pain....

jbuzz
01-11-2004, 09:51 PM
prsch132... for my own information, could you please explain how the chiropractors in your family make $500,000 to $700,000 per year? I'm just interested to see what they charge for services, work hours, and how that all adds up etc.... to $500,000 to $700,000. Or if any chiropractors could explain, that would be OK.

prsch132
01-11-2004, 10:33 PM
Really, it does not matter what a doctor charges, it only matters what the insurance will pay. Insurance will typically pay about $80 total for the patient visit (manipulation) and physical therapy modalities (like traction, therapeutic exersice, e-stim, ect). Most docs in my family see 60-80 patients per day, so we will use 70 pts as an average. Remember, manipulation is a small part of the usal treatment for most conditions and takes less time than therapy. That is one reason therapy is reimbursed at a higher rate. The doctor only has to see the patient for a few minutes for the manipulation, depending on the condition. (But, usually will spend 30 or so on the first couple of visits for history, orthopedics, ect). Anyway, you can do the math. 70 patients x $80 = $5,600 per day. Most of us work 3 days per week. That is $16,800 per week, $67,200 per month, and $806,400 per year. Well, you always bring in less than what you bill for. This figure does not include prices for radiology, new patient exams, ect. It may seem high for pay, but most DCs do not see as many patients. Also, when this is done in a hosptial (or by an MD), the insurance will pay more and have unlimited benefits. If there were one MD that got paid to do this, especially in a hospital, they would get paid much more than a DC. Physical therapy is not like rocket-science, but MDs and hospitals still use them at their cost. It is not law that they do all of the therapy. There are only 50,000 chiros in the US, and 8/10 people have LBP. This does not include headaches, tingling, numbness, ect. So, the offices are a little more crowded, especially if they are wanting to find one that is not a quack.

I know that people say....well the reason you see that many people per day is that they keep coming back....well you should read my previous post on this thread as to why it is important to see them agressively at the START of a treatment plan. Manipluations are not like moving blocks of wood. They are more like getting braces on your teeth. It takes repeated work with liagaments, muscles, and bones to creat a permantent change, like restoring a cervical curve. People with loss of cervical lordosis and anterior head carriage haveheadaches all the time. I can tell you if a person has frequent headaches just by looking at the condition of their neck on a lateral cervical. That curve is there to protect the neck from stress. Next time you see a lateral cervical view, you can see ostrophytosis and discogenic spondylosis at the C/T junction because the lack of proper cervical shape has worn down the joint. What would happen to your hip if you favored one leg for 6 months or 6 years? It would degenrate. The spine is just the same. It would be malpractice to tell a patient that you "popped" something into place. It does not happen. You can't fix such a thing without work. To help a patient with headaches, you have to make a structural change. After all...what would happen if you took your braces of your teeth too early??

azskeptic
01-11-2004, 10:38 PM
Really, it does not matter what a doctor charges, it only matters what the insurance will pay. Insurance will typically pay about $80 total for the patient visit (manipulation) and physical therapy modalities (like traction, therapeutic exersice, e-stim, ect). Most docs in my family see 60-80 patients per day, so we will use 70 pts as an average. Remember, manipulation is a small part of the usal treatment for most conditions and takes less time than therapy. That is one reason therapy is reimbursed at a higher rate. The doctor only has to see the patient for a few minutes for the manipulation, depending on the condition. (But, usually will spend 30 or so on the first couple of visits for history, orthopedics, ect). Anyway, you can do the math. 70 patients x $80 = $5,600 per day. Most of us work 3 days per week. That is $16,800 per week, $67,200 per month, and $806,400 per year. Well, you always bring in less than what you bill for. This figure does not include prices for radiology, new patient exams, ect. It may seem high for pay, but most DCs do not see as many patients. Also, when this is done in a hosptial (or by an MD), the insurance will pay more and have unlimited benefits. If there were one MD that got paid to do this, especially in a hospital, they would get paid much more than a DC. Physical therapy is not like rocket-science, but MDs and hospitals still use them at their cost. It is not law that they do all of the therapy. There are only 50,000 chiros in the US, and 8/10 people have LBP. This does not include headaches, tingling, numbness, ect. So, the offices are a little more crowded, especially if they are wanting to find one that is not a quack.

I know that people say....well the reason you see that many people per day is that they keep coming back....well you should read my previous post on this thread as to why it is important to see them agressively at the START of a treatment plan. Manipluations are not like moving blocks of wood. They are more like getting braces on your teeth. It takes repeated work with liagaments, muscles, and bones to creat a permantent change, like restoring a cervical curve. People with loss of cervical lordosis and anterior head carriage haveheadaches all the time. I can tell you if a person has frequent headaches just by looking at the condition of their neck on a lateral cervical. That curve is there to protect the neck from stress. Next time you see a lateral cervical view, you can see ostrophytosis and discogenic spondylosis at the C/T junction because the lack of proper cervical shape has worn down the joint. What would happen to your hip if you favored one leg for 6 months or 6 years? It would degenrate. The spine is just the same. It would be malpractice to tell a patient that you "popped" something into place. It does not happen. You can't fix such a thing without work. To help a patient with headaches, you have to make a structural change. After all...what would happen if you took your braces of your teeth too early??

For those who haven't seen it, some of the 'high speed' chiropractors have suites of 10-12 examining rooms..they have 'aides' positioning the people...they come in,wham bam,thank you mam, and the aid stays and applies heat or massage machines to the people...an average of 5 minutes to a patient......maybe stick some acupuncture needles in if they are a 'mixer' i.e. one who does several things other than chiropractic...sell a few vitamins/'prescribed' herbs,etc. There are 'workshops' to help people catch on to this style.

az skeptic

neilc
01-11-2004, 10:47 PM
To help a patient with headaches, you have to make a structural change. After all...what would happen if you took your braces of your teeth too early??

do you have any research for this? i know that there is some contraversy about cervical manipulation and causing injury, as well as some signifcant data that shows it is effective for headache treatment. however, i don't know what kind of effect i would expect from chiropractic as regards to making a positive/beneficial structural change in an area of degeneration. the evidence i have seen supports increased range of motion as the likely basis for improvement. and if increasing range of motion is the objective, i would opt for ROM excercises, massage, ultrasound vs. c-spine adjustment.

thanks.

prsch132
01-11-2004, 10:55 PM
As I said, the manipulation does not require that much time. If you are in there longer than that, you aren't focused on what the petient is there for. But I do see how you could refer to some places as a workshop. This is one reason so many fail (besides all of the quacks). You have to work for yourself. Make it or break it. As an MD, you can walk into an established hospital and get a salary.
In our clinics each doctor only has 2 treatment rooms. I just go back an forth all day. PT is not done right there. We have an entire place dedicated to therapy and rehab. It is not a 5 minute trip. They are at EACH therapy for at least 15 minutes. You can't truely get anything done in 5 minutes.

azskeptic
01-11-2004, 11:12 PM
As I said, the manipulation does not require that much time. If you are in there longer than that, you aren't focused on what the petient is there for. But I do see how you could refer to some places as a workshop. This is one reason so many fail (besides all of the quacks). You have to work for yourself. Make it or break it. As an MD, you can walk into an established hospital and get a salary.
In our clinics each doctor only has 2 treatment rooms. I just go back an forth all day. PT is not done right there. We have an entire place dedicated to therapy and rehab. It is not a 5 minute trip. They are at EACH therapy for at least 15 minutes. You can't truely get anything done in 5 minutes.

to do 80 in a 10 hour day you can't spend more than 7 minutes each,even if you don't take a bathroom/lunch break......

az skeptic

prsch132
01-11-2004, 11:13 PM
NEILC,
I understand what you are saying. The a single adjustment is not going to cause an improvement in a person with headaches. It is repeated therapy, manipulation, exercise, increased ROM, ect. Manipulation does cause a dramatic increase in ROM. I can get studies on restoring cervical curves. I could even show you things I have done (being HIPPA compliant). You cannot reverse degeneration, but you can prevent if from happening, slow it, and provide relief. As for the safety, it is very safe. About 1/10,000,000 have a vertibrobasilar accident, and these are people that would stroke out while looking over their shoulder to back their car out.
Also, you can't just stretch someone and improve headaches. Most people with headaches have restricted joints. So, if you do an AP cervical film while the pt actively laterally bends the neck, you will see some vertebra move good, while some are completely in-line with eachother, showing there is no motion between them. That is the area that needs specific adjustment. Actually, when there is a fixation, and you stretch the entire neck, it is not going to move the fixated area. It is actually going to keep stretching the hypermobile areas above and below the area of fixation. That WILL cause a headache. You need to give a specific blow to that fixated area. If you have patients with headaches, ask them questions. Like.....is your headache behind an eye. The cervical roots that cause this are at C2 on the ipsilateral side. Feel it. It will be more taught and tender than the left side. Tissue irritation at the C2 level is causing radiation to the eyeball region. And....if you did AP lateral flexion radiographs, you just might see a loss of motion to the upper cervicals. I would want to adjust C2 and do ultrasound here, rather then do a general manipulation and stretch the entire neck.....at least in the acute phase. What you suggest is good.

prsch132
01-11-2004, 11:17 PM
We work 7-7 with a 2 hour lunch. That is 8.5 minutes for the manipulation ONLY. And this is with an established patient....not a new one. The patient is usually getting treatment for well over 30 minutes. There is more the chiropractic than just popping things, maybe that is why people thing we are so limited in our scope.

neilc
01-11-2004, 11:39 PM
NEILC,
I understand what you are saying. The a single adjustment is not going to cause an improvement in a person with headaches. It is repeated therapy, manipulation, exercise, increased ROM, ect. Manipulation does cause a dramatic increase in ROM. I can get studies on restoring cervical curves. I could even show you things I have done (being HIPPA compliant). You cannot reverse degeneration, but you can prevent if from happening, slow it, and provide relief. As for the safety, it is very safe. About 1/10,000,000 have a vertibrobasilar accident, and these are people that would stroke out while looking over their shoulder to back their car out.
Also, you can't just stretch someone and improve headaches. Most people with headaches have restricted joints. So, if you do an AP cervical film while the pt actively laterally bends the neck, you will see some vertebra move good, while some are completely in-line with eachother, showing there is no motion between them. That is the area that needs specific adjustment. Actually, when there is a fixation, and you stretch the entire neck, it is not going to move the fixated area. It is actually going to keep stretching the hypermobile areas above and below the area of fixation. That WILL cause a headache. You need to give a specific blow to that fixated area. If you have patients with headaches, ask them questions. Like.....is your headache behind an eye. The cervical roots that cause this are at C2 on the ipsilateral side. Feel it. It will be more taught and tender than the left side. Tissue irritation at the C2 level is causing radiation to the eyeball region. And....if you did AP lateral flexion radiographs, you just might see a loss of motion to the upper cervicals. I would want to adjust C2 and do ultrasound here, rather then do a general manipulation and stretch the entire neck.....at least in the acute phase. What you suggest is good.

here is a study comparing mobilization vs. manipulation in neck pain:

A randomized trial of chiropractic manipulation and mobilization for patients with neck pain: clinical outcomes from the UCLA neck-pain study.
Am J Public Health 2002 Oct;92(10):1634-41 (ISSN: 0090-0036)
Hurwitz EL; Morgenstern H; Harber P; Kominski GF; Yu F; Adams AH
Department of Epidemiology, UCLA School of Public Health, University of California-Los Angeles, Box 951772, Los Angeles, CA 90095-1772, USA. [email protected]
OBJECTIVES: This study compared the relative effectiveness of cervical spine manipulation and mobilization for neck pain. METHODS: Neck-pain patients were randomized to the following conditions: manipulation with or without heat, manipulation with or without electrical muscle stimulation, mobilization with or without heat, and mobilization with or without electrical muscle stimulation. RESULTS: Of 960 eligible patients, 336 enrolled in the study. Mean reductions in pain and disability were similar in the manipulation and mobilization groups through 6 months. CONCLUSIONS: Cervical spine manipulation and mobilization yield comparable clinical outcomes.
Comment In: Comment In: RefSource:ACP J Club. 2003 Mar-Apr; 138(2):48/PMID:12614133

i did find lots of results supporting what you say, but the research is a bit weak. lots of retroactive, non-randomized studies from the records of a single practitioner and such. i would like to see some controlled, large studies if you have any access, or if they have been done.

as far as i can tell, the larger randomized studies show little difference when the compare mobilization vs. manipulation.

neilc
01-11-2004, 11:57 PM
well, i keep looking at the research. and i am still not convinced. you say that you need to "give a specific blow to the fixated area". well, the research i see says that this is no more effective than mobilization and/or excercise.

from what i read, chiropractic is not better than PT. i don't have any problem admitting at the very least equality, and possibly that i am missing some research that supports what you say. but, i would be hesitant to send a patient out for a chiropractic adjustment, when there are some risks (admittedly pretty low risk). the other benefit of the PT. they will stick to what is shown to work with studies, and i don't have to worry about whether what you are doing is scientific or not.

i do understand that lots of patients feel better when they go to the DC. that is great, and whether it is the placebo effect of the result of therapy, i am glad the patients are happy. i just can't justify refering patients for that type of therapy. now, if they go of thier own accord, it is fine with me, and i can suppor that. anyhow, i would love to see some of the abstracts, etc...as long as it is not anecdotal evidence (that is not very useful) and is a part of a well designed study.

here is another abstract:
Chiropractic spinal manipulation for neck pain: a systematic review.
J Pain 2003 Oct;4(8):417-21 (ISSN: 1526-5900)
Ernst E
Complementary Medicine, Peninsula Medical School, Universities of Exeter & Plymouth, Exeter, United Kingdom. [email protected]
Chiropractic spinal manipulation (CSM) is often used as a treatment for neck pain. However, its effectiveness is unclear. The aim of this article was to evaluate systematically and critically the effectiveness of CSM for neck pain. Six electronic databases were searched for all relevant randomized clinical trials. Strict inclusion/exclusion criteria had been predefined. Key data were validated and extracted. Methodologic quality was assessed by using the Jadad score. Statistical pooling was anticipated but was deemed not feasible. Four studies met the inclusion/exclusion criteria. Two studies were on single interventions, and 2 included series of CSM treatments, both with a 12-month follow-up. The 2 short-term trials used spinal mobilization as a control intervention. The 2 long-term studies compared CSM with exercise therapy. None of the 4 trials convincingly demonstrated the superiority of CSM over control interventions. In conclusion, the notion that CSM is more effective than conventional exercise treatment in the treatment of neck pain was not supported by rigorous trial data.

AUCMD2006
01-12-2004, 09:54 AM
a sports rehab complex and that is either before overhead, massive hmo contracts, or 6 visits a day per patient...if i could make 500k without a college degree why go through med school?

azskeptic
01-12-2004, 10:02 AM
a sports rehab complex and that is either before overhead, massive hmo contracts, or 6 visits a day per patient...if i could make 500k without a college degree why go through med school?

this is sort of like the fabled 'I bought a Mercedes from a guy's wife who caught him cheating for $100..she wanted to get even' type story...it must happen but it is pretty rare.

I have a chiropractor friend in Phoenix who has made the big money over the years,invested well, and works 3 days/week also...but the eroding insurance payment (the most important thing since people are reluctant to pay for services themselves), the limiting of number of times you can see a chiropractor, and the competition for patients by medical/physical therapy clinics,etc. and the oversupply of chiropractors means that it isn't a guaranteed thing anymore.

Do a search on yahoo and read about chiropractors having problems finding jobs...working for $12/hour for other chiroprctors,etc. and it will remind you that med school is a good place to be....the number of DC's who are on this forum these days also are an indication.....old guys (40-50's) going back to school because they see their 'gravy train' is over.

az skeptic

azskeptic
01-12-2004, 10:19 AM
a sports rehab complex and that is either before overhead, massive hmo contracts, or 6 visits a day per patient...if i could make 500k without a college degree why go through med school?

Here are some 'practice' building ideas you can listen to by calling in on chiroview

http://www.chiropracticgateway.com/gateway-users/chirochatschedule.aspx

AUCMD2006
01-12-2004, 06:29 PM
"what to say when a patient is no longer in pain but has not completed their treatment"

it should read what to do when the pain is gone but the limits on the policy haven't run out yet....

prsch132
01-12-2004, 07:46 PM
RROD, You obviously don't understand the difference between correcting a disorder and hiding it. That is the way most doctors of medicine seem to think. This is what you said:

"what to say when a patient is no longer in pain but has not completed their treatment"

it should read what to do when the pain is gone but the limits on the policy haven't run out yet.... "

You can't just release a patient from care when they feel fine. You OBJECTIVELY treat a patient. I assume you have been to a dentist? Why? Do you going when your teeth hurt? Would you believe you had a cavity if the dentist said you did, but the tooth did not hurt? Is it ok to tell a diabetic patient to eat what they want now that they have no ulcers on their legs? Is it ok to walk on a spiral fracture of the tibia when the pt feel fine 2 weeks post-surgery? Every patient I have MUST pay their co-pay. They MUST pay the deductible. And, if their benefits run out, they will be paying out of pocket. Otherwise, they are not serious about their health. I NEVER have a problem with patients, even if they are cash, because they understand why they are their and correction is what they need. If you want temporary relief.....just take an aspirin! I am there to CORRECT.

azskeptic
01-12-2004, 08:13 PM
RROD, You obviously don't understand the difference between correcting a disorder and hiding it. That is the way most doctors of medicine seem to think. This is what you said:

"what to say when a patient is no longer in pain but has not completed their treatment"

it should read what to do when the pain is gone but the limits on the policy haven't run out yet.... "

You can't just release a patient from care when they feel fine. You OBJECTIVELY treat a patient. I assume you have been to a dentist? Why? Do you going when your teeth hurt? Would you believe you had a cavity if the dentist said you did, but the tooth did not hurt? Is it ok to tell a diabetic patient to eat what they want now that they have no ulcers on their legs? Is it ok to walk on a spiral fracture of the tibia when the pt feel fine 2 weeks post-surgery? Every patient I have MUST pay their co-pay. They MUST pay the deductible. And, if their benefits run out, they will be paying out of pocket. Otherwise, they are not serious about their health. I NEVER have a problem with patients, even if they are cash, because they understand why they are their and correction is what they need. If you want temporary relief.....just take an aspirin! I am there to CORRECT.

where we have problems is that I believe chiropractic care has shown to be effective in only limited ways...i.e. lower back pain..and even that can be treated by osteopaths more effectively (meds and manipulation) and by PT's. Basically in many people's view chiropractic is fairly underpowered in doing much more than giving temporary 'feeling better' feelings. read the stuff at:

http://www.chirobase.org/

AUCMD2006
01-13-2004, 08:53 PM
i was just being cynical, i thought it was a funny statement and have seen similar ones at medical conferences "getting the most out of medicare billing" and such. i have no doubt that chiros help people the image is just so tarnished! beleive me when i worked in a docs office there was nothing i liked more than to send patients with non-complicated aches and pains to a chiro for manipulation and epidural shots, if it were allowed but anytime i sent anyone to chiro practices they ended up using their 10 vistits under hmo contract in two weeks no matter how severe or mild it was and hassiling me for referral overrides which 99.9% of the time were denied by the medical director for lack of medical nesessity, one practice even had them see a optometrist, dentist, and a podiatrist the same day at the same complex without my authorization! wonder what kind of kick back he got. after that i talked to the medical director and changed office policy to only refer to ortho and neuro so the bad element in the profession is ruining it for a lot of new chiros. the dysfunction, bickering and difference in treatment theory in your professional organization will make it impossible to lobby for a change in law to grant limited prescription privilidges to you like the psychologists are doing for psych meds

dsfx
01-14-2004, 11:17 AM
Do you ever think before you talk. Who made you the self proclaimed expert on chirpractic. I know you have friends apparently that are chiro's but you take every opportunity you can at discrediting the proffession. Why do I bother?

stephew
01-14-2004, 11:33 AM
Remember: personal insults are a violation of TOS and may result in warnings or banning. Also endless arguing in public is nothing so much as chronically trying to get the last word in. I hate to break it to you but no gets "enlightened" by heated arguments.
So "good question" is an answer to your question "why bother".







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