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azskeptic
04-01-2004, 09:25 AM
http://www.chiroweb.com/columnist/meemoophil/index.html

The Changing Face of Chiropractic Education - A Corollary
by Reed Phillips, DC, PhD
I take the title of this article from a recent (March 1, 2004) editorial by Donald M. Petersen, Jr., editor and publisher of Dynamic Chiropractic. I do so partly because what was put into print is now out of date; it would appear the emphasis should be on "The Changing Face."

My goal is not to detract from the good words of Mr. Petersen, but rather, to add a second voice of concern from someone who stands a little closer to the fire. Mine is a voice of concern - for as our educational establishments go, eventually so goes the profession.

What is this "changing face of chiropractic education"?

Mr. Petersen commented on the declining enrollment within the chiropractic programs in the U.S., indicating it "... has dropped by more than 30 percent in the past seven years." Depending on the source of information, this percent of decline may vary from 20 percent to 40 percent, but the presence of a decline is constant. Furthermore, the precipitous nature of this decline seems to have been more severe in the past three years.

While the trend of continued declining enrollments could spell disaster for the future of the profession, it is often discounted with comments such as, "It is happening to all the health professions." This statement is certainly true (except in medicine, where there is a decline in inquiries, but not enrollments), but when used as justification for non-action, one is certainly adopting a "head-in-the-sand" attitude.

With the unprecedented acceptance of "alternative therapies" by the American public, it is befuddling that so few people are pursuing careers in chiropractic, one of the more recognized and scientifically substantiated of the "alternative therapies." There are many reasons (excuses) that might be offered by way of explanation for the decline in enrollments; I will focus on only one.

The Image of Chiropractic Education

We lay claim to being "doctors." I believe the public generally can distinguish between a doctor associated with health care and a doctor associated with academia. The social standard in health care in the U.S. is the MD, or medical doctor, while the social standard in academia is the PhD, or the doctor of philosophy in a particular field of study. A comparison of the DC and PhD degrees is not appropriate because of how they differ; thus, I will remark on the comparison between the DC and the MD.

Let's start with the fact that nearly 100 percent of students enter medical school with high scholastic performance and a bachelor's degree from a major university. Contrast this with the long-term debate in chiropractic education as to whether the profession should advance its entrance requirements from 60 units at the junior college level of training to 90 units leading toward a bachelor's degree, over which some chiropractic educational institutions/programs still complain.

For years, chiropractic has attempted to equate chiropractic education with medical education by drawing attention to the similarity in the number of classroom hours and subject matter. If chiropractic students sit in classrooms equal in time to the medical students, does that make the two programs equal? Seat time is a poor measure of quality education.

One could contrast (and the public probably does) the difference between the facilities, resources and experienced faculty in chiropractic and medical education. Yes, all chiropractic programs have regional accreditation (except two in California) by the same agencies that accredit the medical programs. One must remember that accreditation is an assurance that an institution and its programs are meeting a minimal level of acceptability. Accreditation is not a measure of achievement or excellence beyond that which is required.

How many Nobel Laureates are teaching in chiropractic education? None! How many chiropractic educational institutions have faculty who are conducting research funded by NIH, or at least NIH-level grants? A few! How many of the PhDs in our chiropractic programs are actually conducting research and publishing their work for the benefit and growth of the profession? And how many DCs in chiropractic educational programs are actually conducting research and publishing their work? A few! Conducting and publishing one's work is a requisite for continued existence in a medical educational institution; it is paid token homage in chiropractic education.

Since this article addresses the "changing face of chiropractic education," I should mention leadership. Of the 16 programs in the U.S., three (Life, Palmer and Palmer West) have named new presidents (or recycled previous presidents) in the past month (as of March 4). Five programs have installed new presidents since 2000 (NYCC, Sherman, Northwestern, TCC and Western States). By contrast, three programs have retained the same presidents since 1981 (Life West, Cleveland LA & KC).

I do not wish to infer that time in service for a president is a valid indicator of the quality of education in a program, but there is a relationship that can be looked at from either end of the spectrum. Can a president sit too long at the helm, causing the program either to lose its direction or be stuck in a rut and not seek new frontiers? Conversely, changing of a president can also be a disruptive process (and usually is, in chiropractic education), leading to a change in mission and vision, loss of other seasoned administrators, financial costs in finding a new president, and many other ramifications that make it a difficult and challenging process.

Now, a bit more about the problem of image: How many readers can name the president of the UCLA School of Medicine? What about the president of UCLA? My point is, chiropractic educational programs historically, and to a lesser degree today, hang on the reputation of the president, e.g., Janse, Napolitano, Haynes and others. While these and others were bright, energetic and dedicated warriors of the cause of chiropractic education, they may have carried their programs more on the basis of their individual charisma than their contributions to the advancement of the profession. There may well be charismatic leaders in medical education, but they also display a high profile of academic achievement, contribute to the growth of new knowledge in their field, and demonstrate their ability to succeed in the academic/clinical arena over which they preside. While chiropractic program presidents come from backgrounds in practice and teaching, only two have achieved the academic credentialing looked upon by the public, as well as the scientific and health care community, as a necessary qualifier to lead an "academic" institution - something chiropractic educational programs claim to be.

Chiropractic education is beset by its high dependence upon the tuition dollar to cover operational costs. As enrollments decline, resources to support the educational endeavor likewise decline. This financial crunch leads to a decreased work force (without an equal reduction in the workload); pay scales below those from non-tuition-dependent programs; less research; and hence, less external funding support and a strain on existing resources and facilities.

Finally, while chiropractic education ends at the conclusion of 10 semesters (and some after nine) of training, medical education, at the end of four years of medical school, typically transitions to a three- to five-year training experience focused in an area of specialty. This advanced residency training experience is an intensive time of supervised teaching, hands-on patient experience, application of knowledge and skills to serious decision-making, and an enculturation experience of the novice trained practitioner into a journeyman. Chiropractic has nothing comparable in the training of its practitioners.

Image is a problem in chiropractic education, but the greater problem is the accumulation of issues previously discussed which germinate and perpetuate our less-than-satisfactory image. My experience chairing the Chiropractic Advisory Committee of the Veteran's Administration is a foreboding example of this problem.

In determining a job classification for the doctor of chiropractic in the Veteran's Health Affairs system, a job analysis was conducted by an independent agency. Close scrutiny of practice patterns and behavior, typical case scenarios covering not only presenting conditions, but also actual treatment protocols (and yes, chiropractic education) provided data that was compared to other health professions currently functioning within the VHA system. It was concluded that the complexity of decision-making in chiropractic practice was considerably less than that of a medical doctor (probably because of the limited case mix seen in chiropractic practice), but more complex than a physical therapist who works under medical prescription. Chiropractic education was determined to be less rigorous and comprehensive than medical education, and most similar to that of the optometrist. I remind the reader that these decisions were arrived at based on the data collected; thus, the basis of our image is largely our own doing (or undoing).

Our image has also been tarnished by the bashing of the Council on Chiropractic Education (CCE) in public forum. Chiropractic publications that accuse the CCE of exercising bias and prejudice are read by more than the devotees of the publishers. The very organization that has brought credibility to chiropractic education is strong and will withstand such blows, but the image of chiropractic and chiropractic education in the eyes of our skeptics has been confirmed. Even in our own profession, those distant from the facts must depend on what they read. When smothered with innuendos, accusations and inaccurate statements of the facts, they too pause to ponder the credibility of our "professional academic enterprise."

The Changing Face of Chiropractic Education

Those of you who graduated pre-CCE (1974) have probably rehearsed (on numerous occasions) the challenges faced by the chiropractic programs of your day. There was no enforcement of educational standards; schools taught what the president said would be taught. Facilities were old, in need of repair, and lacked necessary teaching aids, especially in laboratories. Libraries (now "learning resource centers") were small, isolated from the rest of the library world, and lacked adequate holdings to offer opportunities for expanded learning. There were no computers. Faculty and administrators often earned their living in clinical practice or other enterprises external to the chiropractic educational program, because the program could not pay a sustainable wage (many faculty were volunteers). Few if any faculty came with an earned graduate degree of any sort, and the basic science courses were often taught by a recent graduate reading to the students from a book. Research was virtually nonexistent.

Therefore, even though we can find much fault with our current situation in chiropractic education, comparatively, chiropractic education has made miraculous historical improvements. Educational standards are enforced fairly and without bias, despite frequent commentaries from overactive pariahs. They have become the "sounding brass and tinkling cymbals" (Corinthians 1:13) of our profession.

Academic freedom is required of every program accredited by the CCE. Academic freedom does not imply an "anything goes" attitude. Propriety and respect must be maintained. The president cannot dictate to the faculty what they shall teach, even though some may still try. While facilities are in need of constant maintenance, and technology continues to advance at light speed, chiropractic educational programs are required to meet these needs in a timely manner. Learning resource centers are connected to the world of cyberspace; technology is everywhere; holdings are current and relevant; and staff is qualified with specialized training in information acquisition and distribution. Faculty and most senior administrators come with experience outside the chiropractic educational world. They enter our portals with graduate degrees in hand. Their experience in higher education brings rich dividends to our programs. Research has become an integral (albeit limited) part of the fabric of each accredited institution.

Conclusion

From an historical perspective, the "face of chiropractic education" has changed in ways that members of the previous generation could only dream of. Are we satisfied? I think not!

We expound with rhetoric regarding unfairness, if not outright discrimination, when we experience the cultural privileges granted to one group of "doctors" and not the other (us). Two cases in point: efforts to eliminate chiropractic from participating in the California State Work Comp system, and restricting doctors of chiropractic from performing physical examinations on commercial drivers because we are "... not trained adequately to assume such responsibility."

If we want parity (and I believe we do), we must first define it. It does not mean that we want to become medical doctors. But I fear we seek parity of benefits without sharing the parity of responsibility. We desire equal respect and recognition, but some in our profession, who are quite vocal, deride educational standards and attainment in the name of "philosophy." (Kant and Hegel must be disgusted.)

If this profession is to thrive (and I think it will always survive because of the good it provides), we must assume the responsibility of being accountable to the public we serve. We (the profession) cannot speak with a "forked tongue" and expect the social acceptance and legitimization we desire. Chiropractic education must rally behind a banner of integrity, willing to submit to the review of our peers (that's what accreditation is all about) and seek to be not only good teachers (which is very, very important), but also purveyors of new knowledge.

Chiropractic education has changed in a dramatic way over the years, and it (and the profession it feeds) must continue transforming its image.

Reed Phillips, DC, PhD
President, Southern California University of Health Sciences
Whittier, California

MitchDC
02-05-2006, 11:02 PM
Dr. Phillips is not only a great leader but a great man. His point is well made and I hope that the profession follows his lead.

-M


http://www.chiroweb.com/columnist/meemoophil/index.html

The Changing Face of Chiropractic Education - A Corollary
by Reed Phillips, DC, PhD
I take the title of this article from a recent (March 1, 2004) editorial by Donald M. Petersen, Jr., editor and publisher of Dynamic Chiropractic. I do so partly because what was put into print is now out of date; it would appear the emphasis should be on "The Changing Face."

My goal is not to detract from the good words of Mr. Petersen, but rather, to add a second voice of concern from someone who stands a little closer to the fire. Mine is a voice of concern - for as our educational establishments go, eventually so goes the profession.

What is this "changing face of chiropractic education"?

Mr. Petersen commented on the declining enrollment within the chiropractic programs in the U.S., indicating it "... has dropped by more than 30 percent in the past seven years." Depending on the source of information, this percent of decline may vary from 20 percent to 40 percent, but the presence of a decline is constant. Furthermore, the precipitous nature of this decline seems to have been more severe in the past three years.

While the trend of continued declining enrollments could spell disaster for the future of the profession, it is often discounted with comments such as, "It is happening to all the health professions." This statement is certainly true (except in medicine, where there is a decline in inquiries, but not enrollments), but when used as justification for non-action, one is certainly adopting a "head-in-the-sand" attitude.

With the unprecedented acceptance of "alternative therapies" by the American public, it is befuddling that so few people are pursuing careers in chiropractic, one of the more recognized and scientifically substantiated of the "alternative therapies." There are many reasons (excuses) that might be offered by way of explanation for the decline in enrollments; I will focus on only one.

The Image of Chiropractic Education

We lay claim to being "doctors." I believe the public generally can distinguish between a doctor associated with health care and a doctor associated with academia. The social standard in health care in the U.S. is the MD, or medical doctor, while the social standard in academia is the PhD, or the doctor of philosophy in a particular field of study. A comparison of the DC and PhD degrees is not appropriate because of how they differ; thus, I will remark on the comparison between the DC and the MD.

Let's start with the fact that nearly 100 percent of students enter medical school with high scholastic performance and a bachelor's degree from a major university. Contrast this with the long-term debate in chiropractic education as to whether the profession should advance its entrance requirements from 60 units at the junior college level of training to 90 units leading toward a bachelor's degree, over which some chiropractic educational institutions/programs still complain.

For years, chiropractic has attempted to equate chiropractic education with medical education by drawing attention to the similarity in the number of classroom hours and subject matter. If chiropractic students sit in classrooms equal in time to the medical students, does that make the two programs equal? Seat time is a poor measure of quality education.

One could contrast (and the public probably does) the difference between the facilities, resources and experienced faculty in chiropractic and medical education. Yes, all chiropractic programs have regional accreditation (except two in California) by the same agencies that accredit the medical programs. One must remember that accreditation is an assurance that an institution and its programs are meeting a minimal level of acceptability. Accreditation is not a measure of achievement or excellence beyond that which is required.

How many Nobel Laureates are teaching in chiropractic education? None! How many chiropractic educational institutions have faculty who are conducting research funded by NIH, or at least NIH-level grants? A few! How many of the PhDs in our chiropractic programs are actually conducting research and publishing their work for the benefit and growth of the profession? And how many DCs in chiropractic educational programs are actually conducting research and publishing their work? A few! Conducting and publishing one's work is a requisite for continued existence in a medical educational institution; it is paid token homage in chiropractic education.

Since this article addresses the "changing face of chiropractic education," I should mention leadership. Of the 16 programs in the U.S., three (Life, Palmer and Palmer West) have named new presidents (or recycled previous presidents) in the past month (as of March 4). Five programs have installed new presidents since 2000 (NYCC, Sherman, Northwestern, TCC and Western States). By contrast, three programs have retained the same presidents since 1981 (Life West, Cleveland LA & KC).

I do not wish to infer that time in service for a president is a valid indicator of the quality of education in a program, but there is a relationship that can be looked at from either end of the spectrum. Can a president sit too long at the helm, causing the program either to lose its direction or be stuck in a rut and not seek new frontiers? Conversely, changing of a president can also be a disruptive process (and usually is, in chiropractic education), leading to a change in mission and vision, loss of other seasoned administrators, financial costs in finding a new president, and many other ramifications that make it a difficult and challenging process.

Now, a bit more about the problem of image: How many readers can name the president of the UCLA School of Medicine? What about the president of UCLA? My point is, chiropractic educational programs historically, and to a lesser degree today, hang on the reputation of the president, e.g., Janse, Napolitano, Haynes and others. While these and others were bright, energetic and dedicated warriors of the cause of chiropractic education, they may have carried their programs more on the basis of their individual charisma than their contributions to the advancement of the profession. There may well be charismatic leaders in medical education, but they also display a high profile of academic achievement, contribute to the growth of new knowledge in their field, and demonstrate their ability to succeed in the academic/clinical arena over which they preside. While chiropractic program presidents come from backgrounds in practice and teaching, only two have achieved the academic credentialing looked upon by the public, as well as the scientific and health care community, as a necessary qualifier to lead an "academic" institution - something chiropractic educational programs claim to be.

Chiropractic education is beset by its high dependence upon the tuition dollar to cover operational costs. As enrollments decline, resources to support the educational endeavor likewise decline. This financial crunch leads to a decreased work force (without an equal reduction in the workload); pay scales below those from non-tuition-dependent programs; less research; and hence, less external funding support and a strain on existing resources and facilities.

Finally, while chiropractic education ends at the conclusion of 10 semesters (and some after nine) of training, medical education, at the end of four years of medical school, typically transitions to a three- to five-year training experience focused in an area of specialty. This advanced residency training experience is an intensive time of supervised teaching, hands-on patient experience, application of knowledge and skills to serious decision-making, and an enculturation experience of the novice trained practitioner into a journeyman. Chiropractic has nothing comparable in the training of its practitioners.

Image is a problem in chiropractic education, but the greater problem is the accumulation of issues previously discussed which germinate and perpetuate our less-than-satisfactory image. My experience chairing the Chiropractic Advisory Committee of the Veteran's Administration is a foreboding example of this problem.

In determining a job classification for the doctor of chiropractic in the Veteran's Health Affairs system, a job analysis was conducted by an independent agency. Close scrutiny of practice patterns and behavior, typical case scenarios covering not only presenting conditions, but also actual treatment protocols (and yes, chiropractic education) provided data that was compared to other health professions currently functioning within the VHA system. It was concluded that the complexity of decision-making in chiropractic practice was considerably less than that of a medical doctor (probably because of the limited case mix seen in chiropractic practice), but more complex than a physical therapist who works under medical prescription. Chiropractic education was determined to be less rigorous and comprehensive than medical education, and most similar to that of the optometrist. I remind the reader that these decisions were arrived at based on the data collected; thus, the basis of our image is largely our own doing (or undoing).

Our image has also been tarnished by the bashing of the Council on Chiropractic Education (CCE) in public forum. Chiropractic publications that accuse the CCE of exercising bias and prejudice are read by more than the devotees of the publishers. The very organization that has brought credibility to chiropractic education is strong and will withstand such blows, but the image of chiropractic and chiropractic education in the eyes of our skeptics has been confirmed. Even in our own profession, those distant from the facts must depend on what they read. When smothered with innuendos, accusations and inaccurate statements of the facts, they too pause to ponder the credibility of our "professional academic enterprise."

The Changing Face of Chiropractic Education

Those of you who graduated pre-CCE (1974) have probably rehearsed (on numerous occasions) the challenges faced by the chiropractic programs of your day. There was no enforcement of educational standards; schools taught what the president said would be taught. Facilities were old, in need of repair, and lacked necessary teaching aids, especially in laboratories. Libraries (now "learning resource centers") were small, isolated from the rest of the library world, and lacked adequate holdings to offer opportunities for expanded learning. There were no computers. Faculty and administrators often earned their living in clinical practice or other enterprises external to the chiropractic educational program, because the program could not pay a sustainable wage (many faculty were volunteers). Few if any faculty came with an earned graduate degree of any sort, and the basic science courses were often taught by a recent graduate reading to the students from a book. Research was virtually nonexistent.

Therefore, even though we can find much fault with our current situation in chiropractic education, comparatively, chiropractic education has made miraculous historical improvements. Educational standards are enforced fairly and without bias, despite frequent commentaries from overactive pariahs. They have become the "sounding brass and tinkling cymbals" (Corinthians 1:13) of our profession.

Academic freedom is required of every program accredited by the CCE. Academic freedom does not imply an "anything goes" attitude. Propriety and respect must be maintained. The president cannot dictate to the faculty what they shall teach, even though some may still try. While facilities are in need of constant maintenance, and technology continues to advance at light speed, chiropractic educational programs are required to meet these needs in a timely manner. Learning resource centers are connected to the world of cyberspace; technology is everywhere; holdings are current and relevant; and staff is qualified with specialized training in information acquisition and distribution. Faculty and most senior administrators come with experience outside the chiropractic educational world. They enter our portals with graduate degrees in hand. Their experience in higher education brings rich dividends to our programs. Research has become an integral (albeit limited) part of the fabric of each accredited institution.

Conclusion

From an historical perspective, the "face of chiropractic education" has changed in ways that members of the previous generation could only dream of. Are we satisfied? I think not!

We expound with rhetoric regarding unfairness, if not outright discrimination, when we experience the cultural privileges granted to one group of "doctors" and not the other (us). Two cases in point: efforts to eliminate chiropractic from participating in the California State Work Comp system, and restricting doctors of chiropractic from performing physical examinations on commercial drivers because we are "... not trained adequately to assume such responsibility."

If we want parity (and I believe we do), we must first define it. It does not mean that we want to become medical doctors. But I fear we seek parity of benefits without sharing the parity of responsibility. We desire equal respect and recognition, but some in our profession, who are quite vocal, deride educational standards and attainment in the name of "philosophy." (Kant and Hegel must be disgusted.)

If this profession is to thrive (and I think it will always survive because of the good it provides), we must assume the responsibility of being accountable to the public we serve. We (the profession) cannot speak with a "forked tongue" and expect the social acceptance and legitimization we desire. Chiropractic education must rally behind a banner of integrity, willing to submit to the review of our peers (that's what accreditation is all about) and seek to be not only good teachers (which is very, very important), but also purveyors of new knowledge.

Chiropractic education has changed in a dramatic way over the years, and it (and the profession it feeds) must continue transforming its image.

Reed Phillips, DC, PhD
President, Southern California University of Health Sciences
Whittier, California

IMG X-Files
04-18-2006, 06:10 PM
From what I've seen in the US and Canada, DC Schools have great medical facilities, laboratories and Radiology departments. The education at DC schools is by far better than most carribean medical schools...considering the caliber of students entering, faculty and facilities......Actually in Canada, many hospitals are now integrating DCs as part of the health care teams..........DCs have alot to offer, especially hands on approach to health care very similar to the physios.....I would love to see more DCs in the hospitals....it will take alot of pressure off all of us...
I think DCs came a long way since the late 60s and early 70s when considered quackary by most of the medical community......Today, many of my colleagues consider DCs and referring to DCs when medicine fail and surgery is not an option....Perhaps Chiropractic will be the first line of MSK Conditions in the near future...

khiro
08-18-2010, 04:21 PM
i enjoyed reading this article back in 2006 but at the time had no knowledge of the current number of graduates from my old chiro college. well, no more. the numbers are in...when i graduated in 1985 there were around 110. this past december 2009, my old school graduated 23.

this speaks volumes about a lot of things, but mostly i think it is an image problem. you see, the student of today can choose between many options what profession they want to work in. information is at the end of the laptop. what freedom!!

chiropractic can not compete against the image of marcus welby, md and most recent; house. and chiros can say (and do) that they don't compete, but in reality your patient is choosing and the image of the medical profession and its approach is very powerful. yes there are the "informed" and non-herd pts. but the majority are of the herd, being led by the md, do, pa, and np.

i have enjoyed being a small part of the healthcare industry, so i would hope that the difference between 110 and 23 still chose HC as a profession; we will never know. it is clear that they did not choose chiropractic.

AgActual
08-19-2010, 11:05 AM
i enjoyed reading this article back in 2006 but at the time had no knowledge of the current number of graduates from my old chiro college. well, no more. the numbers are in...when i graduated in 1985 there were around 110. this past december 2009, my old school graduated 23.

Is that 23 number the graduates for all of 2009 or just for those graduating in December? I think that would be understandable if that was just the class that graduated in December, since most students graduate in May.

One thing i am more confused about is the 110 graduates back in 1985. 110 graduates a year today would be a fairly small number. Life and Life West alone graduate over 800 students a year and my school, which is one of the smallest chiro schools around, still has 150-200 a year. Which school did you graduate from, if you don't mind me asking? Was it fairly new back in 1985?

AgActual
08-19-2010, 11:06 AM
Double post

AgActual
08-19-2010, 11:10 AM
triple post

AgActual
08-19-2010, 11:18 AM
quadruple post....god what the hell happened?!

rabbitgti20
08-20-2010, 07:57 AM
I agree that the chiropractic profession must continue to transform its image.

khiro
08-23-2010, 12:04 PM
the december 2009 class had 23 or so grads. its a 10 trimester program, so this would have been the september entering class of 2006. for the year, the numbers would have been close to 60 or so grads. thats right, the one graduating class of december 1985 in numbers swamped the whole year of 2009. back in 85 the classes were fairly the same in size, so i would say that TCC would have graduated around 300 or so for a yearly number. and as stated previously the 2009 number was around 60. now these 2009 numbers are coming from me counting the number of individuals lined up and looking sharp in a grad photo. could it be that some grads were not in the official photo? yes i suppose, but most would have been in the pictures. why the decrease in enrollment? did TCC institute some new higher level of standard for matriculation? could have, i don't know. just numbers of course do not tell the whole story about an individual or an institutions progress; but i bring it up just to point out that students who are smart have lots of choices today. tons, and tons, and tons. there are plenty of options for young people today, and in houston texas it is just mind boggling what a student can do.

i'm hoping my son will go into the maritime systems engineering at TAMUG. just a big ole pile of opportunity.

anyway, there is no doubt that there are too many chiropractors to be supported by private insurance, cash patients, etc.. some people believe this and some don't. doesn't matter to me one way or the other. its a change that i wanted to point out.

Crane
08-23-2010, 09:10 PM
the december 2009 class had 23 or so grads. its a 10 trimester program, so this would have been the september entering class of 2006. for the year, the numbers would have been close to 60 or so grads. thats right, the one graduating class of december 1985 in numbers swamped the whole year of 2009. back in 85 the classes were fairly the same in size, so i would say that TCC would have graduated around 300 or so for a yearly number. and as stated previously the 2009 number was around 60. now these 2009 numbers are coming from me counting the number of individuals lined up and looking sharp in a grad photo. could it be that some grads were not in the official photo? yes i suppose, but most would have been in the pictures. why the decrease in enrollment? did TCC institute some new higher level of standard for matriculation? could have, i don't know. just numbers of course do not tell the whole story about an individual or an institutions progress; but i bring it up just to point out that students who are smart have lots of choices today. tons, and tons, and tons. there are plenty of options for young people today, and in houston texas it is just mind boggling what a student can do.

i'm hoping my son will go into the maritime systems engineering at TAMUG. just a big ole pile of opportunity.

anyway, there is no doubt that there are too many chiropractors to be supported by private insurance, cash patients, etc.. some people believe this and some don't. doesn't matter to me one way or the other. its a change that i wanted to point out.

Is chiropractic a legitimate branch of medicine? Do the treatment modalities help the patients on a long-term or permenant basis? Is chiropratic merely a supportive therapy or is it a cure?

khiro
08-24-2010, 10:17 AM
Is chiropractic a legitimate branch of medicine? Do the treatment modalities help the patients on a long-term or permenant basis? Is chiropratic merely a supportive therapy or is it a cure?

first; chiropractic is not a branch of organized medicine (md, do). neither is dental, or optometry or podiatry. i have not closely watched the inner workings of pods, or optometry or dentistry and of the three it appears to me that the one that clearly stands alone is dentistry. do they do medicine? for the mouth and teeth, yes. what about the old eye doc? does s/he do medicine? well, they certainly take care of your eyes, give you some drops for infection. i think they could certainly come under the title of doctor. lets mention the foot doctor. stinky feet and hammer toes; is he a doctor and does he do medicine. i know they do foot surgery and give out meds afterward; that sure sounds like a speciality to me. now, what about the "punch doctor" or chiropractor to everyone outside of the south? does he do "medicine"? he sure doesn't give out any pills for anything, not even muscle relaxers, or little pain meds. doesn't sound too much like a doctor to me. maybe a technician. no s/he went a long time to school. it qualifies s/he to be called a doctor (if anyone is interested), but not in the usual sense of any other doctor. think the public might be a little confused? most of them are. a few are not.

as far as the success of the treatments toward different spinal and muscle ailments my honest assessment is that the chiro will have the same percentage of pts who "get fixed" and the ones who don't "get fixed" as the others in healthcare. as i told a young lady yesterday, sometimes you don't get fixed. you remain broken, so suck it up, and as my 5 year old daughter tells me, take it like a man daddy.

the young lady was here b/c she had seen all of the others (neurologist, family doc, orthopedist, physical therapist, and probably some others) i sent her back to the orthopedist.

btw, there is a DO in town who never "fixes" anyone. doing pretty well dragging all of that medicare and medicaid money to the bank every day.

Crane
08-24-2010, 12:44 PM
first; chiropractic is not a branch of organized medicine (md, do). neither is dental, or optometry or podiatry. i have not closely watched the inner workings of pods, or optometry or dentistry and of the three it appears to me that the one that clearly stands alone is dentistry. do they do medicine? for the mouth and teeth, yes. what about the old eye doc? does s/he do medicine? well, they certainly take care of your eyes, give you some drops for infection. i think they could certainly come under the title of doctor. lets mention the foot doctor. stinky feet and hammer toes; is he a doctor and does he do medicine. i know they do foot surgery and give out meds afterward; that sure sounds like a speciality to me. now, what about the "punch doctor" or chiropractor to everyone outside of the south? does he do "medicine"? he sure doesn't give out any pills for anything, not even muscle relaxers, or little pain meds. doesn't sound too much like a doctor to me. maybe a technician. no s/he went a long time to school. it qualifies s/he to be called a doctor (if anyone is interested), but not in the usual sense of any other doctor. think the public might be a little confused? most of them are. a few are not.

as far as the success of the treatments toward different spinal and muscle ailments my honest assessment is that the chiro will have the same percentage of pts who "get fixed" and the ones who don't "get fixed" as the others in healthcare. as i told a young lady yesterday, sometimes you don't get fixed. you remain broken, so suck it up, and as my 5 year old daughter tells me, take it like a man daddy.

the young lady was here b/c she had seen all of the others (neurologist, family doc, orthopedist, physical therapist, and probably some others) i sent her back to the orthopedist.

btw, there is a DO in town who never "fixes" anyone. doing pretty well dragging all of that medicare and medicaid money to the bank every day.

I am the first to admit I know next to nothing about chiropractic as a profession or otherwise. But I get the feeling that as a chiropractor, you are not that convinced about the field you practice in. This is not comforting to an outsider.

I really don't understand the need for the duplicative profession of DO. I have been to a few and they all practice mainstream medicine just like MDs. I doubt very many, if any of them, do any manipulations as adjunctive therapy. These guys are just a lower tier of pre-med students getting into traditional medicine through an alternative route. The same way that many people get into medicine through off-shore med schools. But the offshore students don't try to differentiate themselves as being something outside of mainstream medicine. I don't understand why DO schools do this and why the DO profession as a whole perpetuates this whole farce? When it comes to public awarness, very few people actually know what DO stands for. In that sense, I think chiropractors are better known by the lay public that are the DOs. I actually know of one case when a woman looking for an optometrist contacted a DO instead. :rolleyes:

maximillian genossa
08-24-2010, 01:49 PM
I think you summarized it pretty well.



first; chiropractic is not a branch of organized medicine (md, do). neither is dental, or optometry or podiatry. i have not closely watched the inner workings of pods, or optometry or dentistry and of the three it appears to me that the one that clearly stands alone is dentistry. do they do medicine? for the mouth and teeth, yes. what about the old eye doc? does s/he do medicine? well, they certainly take care of your eyes, give you some drops for infection. i think they could certainly come under the title of doctor. lets mention the foot doctor. stinky feet and hammer toes; is he a doctor and does he do medicine. i know they do foot surgery and give out meds afterward; that sure sounds like a speciality to me. now, what about the "punch doctor" or chiropractor to everyone outside of the south? does he do "medicine"? he sure doesn't give out any pills for anything, not even muscle relaxers, or little pain meds. doesn't sound too much like a doctor to me. maybe a technician. no s/he went a long time to school. it qualifies s/he to be called a doctor (if anyone is interested), but not in the usual sense of any other doctor. think the public might be a little confused? most of them are. a few are not.

as far as the success of the treatments toward different spinal and muscle ailments my honest assessment is that the chiro will have the same percentage of pts who "get fixed" and the ones who don't "get fixed" as the others in healthcare. as i told a young lady yesterday, sometimes you don't get fixed. you remain broken, so suck it up, and as my 5 year old daughter tells me, take it like a man daddy.

the young lady was here b/c she had seen all of the others (neurologist, family doc, orthopedist, physical therapist, and probably some others) i sent her back to the orthopedist.

btw, there is a DO in town who never "fixes" anyone. doing pretty well dragging all of that medicare and medicaid money to the bank every day.

khiro
08-25-2010, 10:32 AM
I am the first to admit I know next to nothing about chiropractic as a profession or otherwise. But I get the feeling that as a chiropractor, you are not that convinced about the field you practice in. This is not comforting to an outsider.

I really don't understand the need for the duplicative profession of DO. I have been to a few and they all practice mainstream medicine just like MDs. I doubt very many, if any of them, do any manipulations as adjunctive therapy. These guys are just a lower tier of pre-med students getting into traditional medicine through an alternative route. The same way that many people get into medicine through off-shore med schools. But the offshore students don't try to differentiate themselves as being something outside of mainstream medicine. I don't understand why DO schools do this and why the DO profession as a whole perpetuates this whole farce? When it comes to public awarness, very few people actually know what DO stands for. In that sense, I think chiropractors are better known by the lay public that are the DOs. I actually know of one case when a woman looking for an optometrist contacted a DO instead. :rolleyes:

as long as i have been in the biz i don't have to be convinced about chiropractic. i only need to be paid. being in chiro is not anywhere near the same as being in medicine. in all facets; from the alpha to the omega. the start to the finish. from matriculation to graduation to residency to facilities to what matters most to the wives, the money. now is chiro helpful to its pts? of course, otherwise it would have died completely out. i have the best pts in the world. they are constantly manipulated about their ailments and treatments by their mds and PAs, by their insurance companies, and the gov't (medicare) (in todays market it is all about the $$), but still decide to try chiro. it is absolutely amazing. and yes you are right about the DOs. if you want to understand the profession, then you have to take the time to read their history. its interesting reading on a wednesday night. then you will see a remarkable profession; one that did the same treatments as chiros, then decided to go a different way. to do this inside of a profession is a monumental task. i have all the respect in the world for the DO profession. when you break it down to individuals, well they are just like you and me; and any md. human. yes there are lots of practicing DOs who could (did) not get into allopathic med school. late in age, lower mcats, etc. doesn't mean they are not capable of being great docs. i would advise anyone interested in medicine to consider the osteopathic route.

everyone has a story, i know a girl who was pretty sharp; graduated from the u of florida. tried to get into med school. didn't happen, taught high school for one yr, went to DO school near tampa. is now in residency in a very sought after speciality. good for her because she didn't sit around waiting for some md school to say ok. and thanks to the DO profession for changing their mission way back there and getting out of doing manipulation only!!

my statement is if you want to do traditional medicine or something close to it, then go MD or DO. period. want to do something off of that? try dental or optometry.

CARICOM-MED
08-25-2010, 10:48 AM
CHIROPRACTIC as in OSTEOPATHIC MEDICINE
It is time to collaborate and move forward:

I think it would great to see the Chiropractic Profession (DC), joining the DO profession (DO).....You can still utilize the art of manipulative therapies, but also practice medicine...

DOs started the same way DCs, but embraced public health, and medicine...while DCs, wanted to isolate themselves, and reserver the practice to "Hands ON only" type of approach..."Subluxation & Adjustments"

The future of medicine is COLLABORATIVE, if Chiropractic want to grow it must embrace, collaborate, and EXPAND the scope of practice, same way OSTEOPATHY did years back, post Andrew Still era...

While many Chiropractic colleges and Universities are advancing their scope, and educational standards (Evidence Based:NUHS, CMCC, Bridgeport U, Northwestern U.) some (Straight DC Schools: Palmer, Parker, Life U, Sherman College.) will keep the profession at its infancy stage, and prevent it from moving forward....

There is no reason to continue and preach "subluxation" in an era of "Google it" :)

Cheers,

Crane
08-25-2010, 11:56 AM
CHIROPRACTIC as in OSTEOPATHIC MEDICINE
It is time to collaborate and move forward:

I think it would great to see the Chiropractic Profession (DC), joining the DO profession (DO).....You can still utilize the art of manipulative therapies, but also practice medicine...

DOs started the same way DCs, but embraced public health, and medicine...while DCs, wanted to isolate themselves, and reserver the practice to "Hands ON only" type of approach..."Subluxation & Adjustments"

The future of medicine is COLLABORATIVE, if Chiropractic want to grow it must embrace, collaborate, and EXPAND the scope of practice, same way OSTEOPATHY did years back, post Andrew Still era...

While many Chiropractic colleges and Universities are advancing their scope, and educational standards (Evidence Based:NUHS, CMCC, Bridgeport U, Northwestern U.) some (Straight DC Schools: Palmer, Parker, Life U, Sherman College.) will keep the profession at its infancy stage, and prevent it from moving forward....

There is no reason to continue and preach "subluxation" in an era of "Google it" :)

Cheers,


But Chiros may be too late for such a drastic makeover. They should have don this decades ago. Now, it is nearly impossible. The DOs and MDs are not going to want to share their ever shrinking pie with the Chiros. The Chiros will have to fight the MDs and DOs if they want to get into mainstream medicine. Pretty tall order!

CARICOM-MED
08-25-2010, 12:26 PM
CHIROPRACTIC SCOPE EXPANSION SUGGESTIONS:
Dear Sir, Don't jump the gun :)

I work in a large medical center, (With DOs/MDs, NPs, RNs, DPMs, Pharm.Ds, and yes few DCs) and currently we see expanded scope of practice for NPs,as well as PAs and Pharm.Ds (Pharmacists "doctors")....ALL can now, practice with VERY large scope...These changes happened in the past 5 years....ALSO, with CAM, NDs are now pushing for expanded scope and recognition, the Naturopaths were almost eliminated, and in the past 5 years, I've seen HUGE growth, and collaboration between NDs and MDs/DOs....BECAUSE, they have shown tremendous interest in public health, and research. While DCs are "stuck" in the "Manual Approach" to disease & prevention.
ONCE, DCs get their act together, and embrace PUBLIC HEALTH, collaborate with their peers, as with themselves, AGREE to standard of care, pursue RESEARCH, etc..then they can surely make it happen...


But Chiros may be too late for such a drastic makeover. They should have don this decades ago. Now, it is nearly impossible. The DOs and MDs are not going to want to share their ever shrinking pie with the Chiros. The Chiros will have to fight the MDs and DOs if they want to get into mainstream medicine. Pretty tall order!

khiro
08-25-2010, 01:15 PM
USHADOC hits the nail on the head, but with a very unwilling majority in the ranks of chiropractors this will never happen. could it happen? i believe with 50k chiros that yes it could. how? a brand new school(s), a brand new image, how about a whole new name?. how hard would it be for a podiatrist to become a fam doc, but still manage feet as well? you establish the education; rewrite the state law(s), and there you go. please tell me how in the world did all of these NPs get to be able to write Rxs?? (i know the answer!) chiros will never see this b/c of the insane bickering among the differents sects. sunni, kurds, and sheites have nothing on the DC profession. leave it to the DOs to teach us a lesson. we think of them as little mds; they are DOs not MDs, and within the medical community they have been stepped on, laughed at, etc (ok not as bad as the pods, and certainly not as bad as the DC) but they have moved forward. putting up schools like a fat man eats donuts. they are not second class any longer. they have most specialities.

my advice:
years ago i wanted a jeep but couldn't afford it. looked around and found an isuzu trooper. same design, great 4x4 but built a little cheaper. and priced a lot cheaper. the japs had taken the design and made the car cheaper. the chiros don't have to invent anything. just copy the DOs and you'll be fine. can't do it? don't want to? ok, then best of luck to you.

greg stanley's article has been mentioned a lot on the internet and i have mentioned it here as well. he has 3 suggestions: limit the number of students; soften the message and rebuild the image; reposition the practice to a secondary position in another business (massage, etc).

personally i like my idea of creating income that is completely out of chiro altogether. both USHADOC and crane have some great insights into the difficulties of re-imaging chiro. but i see no signs of chiro moving medically.

AgActual
08-25-2010, 01:39 PM
I think it would great to see the Chiropractic Profession (DC), joining the DO profession (DO)I am not sure if i can agree with that. I would definitely like the field to become far more cooperative with MD's and DO's (and vice versa) but i don't think it is necessary for chiros to basically become more or less medical doctors. I believe that MD's and DO's have medicine covered. Here is where I think the field needs to go.

First, drop the subluxation stuff entirely. There is no evidence that a misaligned spine can cause infections, allergies, mental problems, developmental problems, or a weakened immune system. Or that spinal manipulation can fix any of these problems. The entire concept was just made up or stolen by some guy 110 years ago. Time to let it go.

Second, while we are at at, throw out all of the other pseudoscientific stuff. No more homeopathy, no more herbalism, no more applied kinesiology. Anything that doesn't have any basis in science needs to be done away with.

Third, base the field on the treatment of MSK conditions, nutrition, and preventative medicine. The main focus should be on non medical, non surgical MSK treatment. I believe that chiro schools should keep teaching manipulation. We know it is good for lower back problems but from what i have seen, some patients also respond to manipulation in other areas, even those outside of the spine (we certainly need more research in those areas). In addition, focus heavily on teaching massage therapy, basic physical therapy techniques (for minor problems, so that we don't encroach on PT's), exercise therapy, cryo and heat therapy, acupuncture, and the use of nutritional supplements that have been shown to be useful for MSK health. Expand the number of treatments available to chiropractors, so that we aren't just relying on manipulations to treat every muscle or skeletal condition under the sun. Then just have a minor focus on nutrition, which would come in handy for all of the athletes that chiropractors treat, and preventative medicine, since that would generally benefit society.

I think shifting the chiropractic in that direction would allow us to carve out our own, legitimate, and focused, section with in mainstream health care and allow us to be distinct enough, so that we aren't stepping on too many people's toes. And the good news, i think, is that a few schools, including National, Western States, Southern California, and Canadian Memorial have moved in that direction, really knocking out the first and third points that i made, in the last decade.

khiro
08-25-2010, 02:43 PM
well with that post AgActual you proved you're not a nut job.

i have a different view of it naturally. there is absolutely no reason there couldn't be a professional buggy whip association. they could meet, talk about designs, applications, and all of the necessary things that go on with buggy whips. then they could have buggy whip schools and have people come and invest in the buggy whip. these people could go back to their hometowns and try and get the public to buy these buggy whips; except the public doesn't want the whips b/c they are now using cars. the responsibility of the profession is to the public AND TO ITS MEMBERS. and yes the profession has come a long way to protect us in letting us use the buggy whip, but has done little in moving us towards the car. you have correctly stated to get rid of anything unscientific (paraphrased) and this should be expanded to include taking care of its membership. what is in the best interest of the members of the chiro profession?? more DD?? the new and improved DD?? at least you have proposed something thoughtful. i thank you for that. is it enough? for whom? well, is it enough for the public? what does the public need? more DD?? more medicine? the public has stated its answer. imho, we just need to listen; AND THEN RESPOND. but for the individual, the student trying to decide what profession or which profession, the choice, at least in my mind, is really clear: buggy whip or car.

now i realize that you are in chiro school, and i wish you the best outcome from the decision you have made. and i hope that the profession will position itself so that you can have a decent career doing what you want to do.

khiro
08-25-2010, 03:49 PM
to read. i did not read this before my previous post, but read it with interest. you can google it.

Redirecting Chiropractic Education and Research to Support Our Future.
Michael Hubka, DC

AgActual
08-25-2010, 04:08 PM
the public has stated its answer. imho, we just need to listen; AND THEN RESPOND. but for the individual, the student trying to decide what profession or which profession, the choice, at least in my mind, is really clear: buggy whip or car.
I think i see where you are coming from. You are saying that there are better routes to take, in order to do the same thing as a chiropractor can do. If you want to treat skeletal problems, it would be wiser to become a medical orthopedist. If you want to perform manipulation, it would be better to become a DO. If you want to do physical therapy, become a DPT. True. One would have more opportunities and be in a safer career as an MD, DO, or PT. But for many in chiropractic, that isn't necessary what they want to do. I don't want to be an MD or a DO. I don't want to prescribe medication, i don't want to treat infections or cardiovascular problems. I don't want to give vaccines (i believe in vaccines, i just don't want to give them), or set broken bones, or perform surgery. Those other fields just aren't what i or many others want to do. They might be safer but for me, it wouldn't be better.

And there is also the issue chiropractic is an inherently risky career choice. Sure there is more risk than other health care fields but compare it to most other careers out there, it is a pretty good route. Even with in health care, i would not say it is the worst choice. Sure there are the really bad ways to go, like acupuncturist or naturopath, which are going to be terrible compared to chiropractic, but i see chiropractic as being more secure than nursing (excluding NP's), mental health, and not much worse than dentistry, podiatry, or optometry.

The truth of the matter is, all career choices have risks and a lot has gone wrong in all of health care in the last 20-30 years, which makes it all that much worse. Understanding the potential pitfalls is important, and chiropractic has its fair share, but eventually you have to go somewhere, and if chiropractic or any field is the right fit, you just have to pull the trigger at some point.

In the end, chiropractic does have problems and ones that can only be described as infuriating. There are a number of pathetic and just embarrassing schools out there. If it was up to me half of the chiro schools in this country would be shut down and the rest would need various degrees of reform. There are too many practitioners just doing what ever the hell they want. They make things up or use pointless and gimmicky diagnostic/treatment methods to simply make money. And we have a good chunk of the public that see us as the used car salesmen of health care. There is a lot of work to do and hopefully the improvements we have seen in the last 10-20 years will continue and will allow chiropractic to move into a legitimate and needed scope of practice, before the public gives up and the field largely dies off. But I really do have a lot of hope, based on the improvements that 5 or 6 of the schools out there have made, which i talked about in my last post, and that fact that many chiros that were trained in a different era, where nonsense was far more rampant, will be retiring soon. We aren't too far off from those that were trained in the mid-1990's, being the senior members with in chiropractic. Hopefully then, the reforms will be rapid and finally get us to where we need to be.

I suppose time will tell.

CARICOM-MED
08-25-2010, 05:05 PM
RE: MOVING CHIROPRACTIC FORWARD
I remember back in the 80s the general opinion of "OSTEOPATH" was similar to the "CHIROPRACTOR" of today, and yet look at the OSTEOPATHIC profession today, 30 years later !!

If the DCs get their act together they can make it happen, the issue here is that they are their own enemy.....too many PALMER & LIFE graduates that believe the "subluxation" theory is science and they can cure and fix everything.....not enough EVIDENCE BASED DCs, from scientific schools like NUHS, CMCC....Once the "fight" between Straight vs. Mixers end :) and BOTH sides agree to a UNILATERAL approach that is viable, ethical, and scientific, only then will we see progress and acceptance.

Until then.....My kids still ask Santa for christmas gifts, but, at the end of the day, we end up using my VISA card....

Cheers everyone :)



I think i see where you are coming from. You are saying that there are better routes to take, in order to do the same thing as a chiropractor can do. If you want to treat skeletal problems, it would be wiser to become a medical orthopedist. If you want to perform manipulation, it would be better to become a DO. If you want to do physical therapy, become a DPT. True. One would have more opportunities and be in a safer career as an MD, DO, or PT. But for many in chiropractic, that isn't necessary what they want to do. I don't want to be an MD or a DO. I don't want to prescribe medication, i don't want to treat infections or cardiovascular problems. I don't want to give vaccines (i believe in vaccines, i just don't want to give them), or set broken bones, or perform surgery. Those other fields just aren't what i or many others want to do. They might be safer but for me, it wouldn't be better.

And there is also the issue chiropractic is an inherently risky career choice. Sure there is more risk than other health care fields but compare it to most other careers out there, it is a pretty good route. Even with in health care, i would not say it is the worst choice. Sure there are the really bad ways to go, like acupuncturist or naturopath, which are going to be terrible compared to chiropractic, but i see chiropractic as being more secure than nursing (excluding NP's), mental health, and not much worse than dentistry, podiatry, or optometry.

The truth of the matter is, all career choices have risks and a lot has gone wrong in all of health care in the last 20-30 years, which makes it all that much worse. Understanding the potential pitfalls is important, and chiropractic has its fair share, but eventually you have to go somewhere, and if chiropractic or any field is the right fit, you just have to pull the trigger at some point.

In the end, chiropractic does have problems and ones that can only be described as infuriating. There are a number of pathetic and just embarrassing schools out there. If it was up to me half of the chiro schools in this country would be shut down and the rest would need various degrees of reform. There are too many practitioners just doing what ever the hell they want. They make things up or use pointless and gimmicky diagnostic/treatment methods to simply make money. And we have a good chunk of the public that see us as the used car salesmen of health care. There is a lot of work to do and hopefully the improvements we have seen in the last 10-20 years will continue and will allow chiropractic to move into a legitimate and needed scope of practice, before the public gives up and the field largely dies off. But I really do have a lot of hope, based on the improvements that 5 or 6 of the schools out there have made, which i talked about in my last post, and that fact that many chiros that were trained in a different era, where nonsense was far more rampant, will be retiring soon. We aren't too far off from those that were trained in the mid-1990's, being the senior members with in chiropractic. Hopefully then, the reforms will be rapid and finally get us to where we need to be.

I suppose time will tell.

khiro
08-25-2010, 05:27 PM
to be just into the schooling part you have a lot of insight into the profession. the profession needs young guys and gals like you. and yes half of our schools need to disappear. i don't think it will happen. the difficulties have been around a long time and have cause many to leave the profession, to which the subluxation guys say they weren't really chiros; they didn't have the big idea; weren't palmer guys; uh, oh some were, well they didn't have ed classes on the dangers of subx, or whatever. do you know how many medical students who go through residency fail to find work? forget about you, what you want to do, what you don't. after school do you feel like you (and other chiros) should have a 100% employment of $50,000? 75% shot of making 100k a yr. 50% of making anything at all a yr? each of us has to make that determination based on a variety of personal criteria. i know there are no guarantees but shouldn't you stack the deck in your favor? shouldn't your profession do everything in its power to see that its members make a decent living? in fact the future of any profession depends on it. i have some news for the chiro leadership and i don't care what they believe in or don't believe in. times have changed, if you don't reposition this profession, then it will slowly dwindle to the point of insignificance. and yes, the ones in leadership now will be long retired or dead.

you can see where the DOs are making progress. heck, when i first started in 1987 there were only a few in my whole area. now there is one (at least) in every town. new schools with adequate enrollment to further strengthen the profession. not chiro. we bicker on increasing the number of hours a prospective student should have before enrolling in chiro college. a disgrace.

the NPs have made huge strides. the PAs are still taking the crumbs, but hey, its less time than med school and for the most part they get to act independently from the md.

almost all providers have made progress professionally over the yrs, but not the chiro. i have enjoyed my time as a chiro and wish the best for those who follow. it will be a different experience than the one i started with; but i hope it can provide whatever you and others are looking for in a job.

CARICOM-MED
08-25-2010, 07:32 PM
CHIROPRACTIC PROGRESS:
Yes, really hoping the profession as a whole will make some fast decisions & move forward...I feel sorry for the science based DCs out there that get bad rep because of the brainwashed palmer/life grads....I've seen some DCs from NUHS & CMCC that were super smart, only to realize they had to compete against "Straight" DCs, many of them even went back to DO or MD programs....and in my opinion should have done that from the start, instead of wasting 4 years in a DC program...

Cheers,


to be just into the schooling part you have a lot of insight into the profession. the profession needs young guys and gals like you. and yes half of our schools need to disappear. i don't think it will happen. the difficulties have been around a long time and have cause many to leave the profession, to which the subluxation guys say they weren't really chiros; they didn't have the big idea; weren't palmer guys; uh, oh some were, well they didn't have ed classes on the dangers of subx, or whatever. do you know how many medical students who go through residency fail to find work? forget about you, what you want to do, what you don't. after school do you feel like you (and other chiros) should have a 100% employment of $50,000? 75% shot of making 100k a yr. 50% of making anything at all a yr? each of us has to make that determination based on a variety of personal criteria. i know there are no guarantees but shouldn't you stack the deck in your favor? shouldn't your profession do everything in its power to see that its members make a decent living? in fact the future of any profession depends on it. i have some news for the chiro leadership and i don't care what they believe in or don't believe in. times have changed, if you don't reposition this profession, then it will slowly dwindle to the point of insignificance. and yes, the ones in leadership now will be long retired or dead.

you can see where the DOs are making progress. heck, when i first started in 1987 there were only a few in my whole area. now there is one (at least) in every town. new schools with adequate enrollment to further strengthen the profession. not chiro. we bicker on increasing the number of hours a prospective student should have before enrolling in chiro college. a disgrace.

the NPs have made huge strides. the PAs are still taking the crumbs, but hey, its less time than med school and for the most part they get to act independently from the md.

almost all providers have made progress professionally over the yrs, but not the chiro. i have enjoyed my time as a chiro and wish the best for those who follow. it will be a different experience than the one i started with; but i hope it can provide whatever you and others are looking for in a job.

AgActual
08-26-2010, 03:04 PM
the profession needs young guys and gals like you.We might just be in luck there. I can really only speak to time at National as an indicator but the student body seems to be mostly in line with my way of thinking. The old chiropractic theories, particularly the subluxation based theories, are widely mocked by the administration, the professors, and the students. Outside of the history classes, such things are no longer taught at National and haven't been for the last 10 years or so. In addition, I have overheard many conversations between students and professors, criticizing schools like Life, Palmer, and Sherman, for being completely backward.

The school isn't perfect though. You can still take homeopathy, as an elective. Not many do but you can. Some students want to use herbalism in their practices. A few students are big on AK and a few other questionable methods. But they seem to be the minority. Many students at National are very much in favor of the reformed chiropractic view and i would have to assume that the other schools, like Western States, Southern California, Northwestern, CMCC, and maybe in NYCC and the University of Bridgeport (maybe Texas too but i honestly know nothing about that school), are quickly heading in that direction or are already there.

Of course, we need to be realistic and look at the flip side, where we still have about 60% of new chiropractors coming out of places like Life, Palmer, Parker, Cleavland, and Sherman. An unfortunate and confusing number, to say the least. It is quite a mountain to overcome.

Still, the statistics on chiropractic philosophy are somewhat promising, with a slow but steady trickle chiropractors into the "reformed" camp occurring every year. As i have said, i am hopeful that pace will increase, as more schools transition over and more of the older chiros begin to retire.

Crane
08-26-2010, 05:46 PM
What are the treatment modalities that are used by the new reformed or evidence based chiros? Do these evidence based approaches actually expand the treatment options? If so, how?

AgActual
08-26-2010, 06:19 PM
What are the treatment modalities that are used by the new reformed or evidence based chiros? Do these evidence based approaches actually expand the treatment options? If so, how?

The treatments center around non-medical (no pain killers and no muscle relaxants) and non surgical options for problems involving muscles, skeletal structures, ligaments, and tendons. There are a number of already established treatments for such conditions. Of course there is the chiropractic go to, which is joint manipulation. This is mostly commonly seen in the spine but it can be used on just about any mobile joint in the body. We know it works pretty much as well as drugs and surgery for lower back pain, and anecdotal evidence will also tell you that for some, it works in many other areas of the body, including the upper back, neck, shoulders, knees, and elbows, although more research is needed.

There is also massage therapy, which has been well established as a treatment for muscle, ligament, and tendon problems. Cryotherapy (ice packs), heat therapy, ultrasound therapy and cold lasers (which supposedly work like heat therapy), physical therapy/rehab techniques, exercise therapy, acupuncture (supposed to work for some lower back pain), diet, and specific nutritional supplements, like chondroitin sulfate and calcium.

There are a number of non-invasive and well researched treatments for musculoskeletal problems, some of which are a real alternative to medication and surgery. Really, if a chiropractor wanted to treat MSK problems and only MSK problems, as some here have indicated that they should, you would need to pull techniques from all of those areas. Any one of those treatment modalities will only work on a limited number of people and for a limited number of conditions, so the more diversity in your treatments, the more patients one can treat.

Currently the only field that would be drawing from all of these treatments is chiropractic and maybe a few physical therapists out there. The fortunate position that we find ourselves in, here in 2010, is that if a student does go to one of the "good" schools, and does want to learn all of those treatments, the option is definitely there. There are quite a few schools where that is possible today. That wasn't the case a few years back but for some chiro schools, MSK treatments have become a major focus. For example, at my school, which is National University of Health Sciences, most of those treatments are built into the curriculum and a student would only need to schedule the right electives to learn all of them. And for the most part, of the students here do. Keep in mind though I don't see any of the good schools being where they need to be and if you ever want an explanation, let me know.

The problem that we have in this field, is that many schools like Life University, Sherman College, Parker, Logan, Palmer, Cleavland, all want chiropractic to a broad based alternative to mainstream medicine, so while they might touch on MSK treatments (except Sherman), their primary focus in on the vertebral subluxation. So they don't get as involved with MSK diagnostics and treatments. Instead, they spend their time hunting for phantom ailments. As a result, many of the students graduating today have a very limited knowledge of musculoskeletal maintenance and treatment.

So to answer your question, if the field changed to the reformed chiropractic philosophy, would their be new treatments available; well yes and no. You can find chiropractors right now that focus on MSK conditions and do all of those things, like massage therapy, rehab, supplements, acupuncture, etc. but most don't. It is possible new treatments would be discovered but right now, there are many that are know and if a chiropractor had mastered all of them, would be an effective healer of MSK problems.

If things changed and the field did reform, you would just find a lot more chiropractors doing those things. Today, i would argue at least 75%, probably more, don't know how to use all of those treatments.

CARICOM-MED
08-26-2010, 06:38 PM
I know that CMCC/NUHS/SCUH/NWUH/BU are all advocates of evidence based practices....I predict that the profession will be split into two in the near future......and the CMCC/NUHS et al will be similar to the DO Approach, while PALMER/SHERMAN will be more like a MT/RMT approach (Manual-Massage only.)

==> Sure hands on massage is great for everyone, but it doesn't CURE anything except your typical muscle sprain/strain...

Cheers :)

AgActual
08-26-2010, 06:44 PM
I know that CMCC/NUHS/SCUH/NWUH/BU are all advocates of evidence based practices....I predict that the profession will be split into two in the near future......and the CMCC/NUHS et al will be similar to the DO Approach, while PALMER/SHERMAN will be more like a MT/RMT approach (Manual-Massage only.)


I suppose it is possible but I would imagine such a move would still be decades away. ;)

I think the first sign that is happening is one of these schools finally developing the D.C.M. degree.

CARICOM-MED
08-26-2010, 07:17 PM
CHIROPRACTIC PROGRESS, DC TO DCM DEGREE:

I know :)same like DMD or DPM....even the DOs are looking into that...as with NMDs..

BTW: found this on Youtube, & online...pretty impressive, I didn't know they had such facilities at Chiropractic College, some better than most medical schools I've been to...

NUHS:
Admissions (http://www.nuhs.edu/show.asp?durki=5)

PARKER:
YouTube- Campus Tour of Parker College of chiropractic (http://www.youtube.com/watch?v=bhjVVRPJr34)

LOGAN:
YouTube- Logan University | College of Chiropractic Admissions Video (http://www.youtube.com/watch?v=wYYQgXo1o44)


I suppose it is possible but I would imagine such a move would still be decades away. ;)

I think the first sign that is happening is one of these schools finally developing the D.C.M. degree.

AgActual
08-26-2010, 07:39 PM
.pretty impressive, I didn't know they had such facilities at Chiropractic College, some better than most medical schools I've been to...I want to go to the Parker Museum :lol:

The school that is supposed to be really nice, campus wise, is NYCC. They took over some defunct university, so i guess they have all the room they would ever need and i hear they spend a fortune on facilities and maintenance.

National is getting better. I think they received some massive donations in the last few years and have really been updating the campus. When i first started, the main building looked like a run down grade school and most of the other buildings had a real 1980's feel to them. They have since renovated and expanded the main building, modernizing all of the classrooms and labs. They have also cleaned up the clinic, the dorms, and bought some new property. The only downside is the library, which is still a POS.

Before i started chiropractic school, i was just a shocked to find out how modern and well equipped some of these schools are. When i found out every chiro school had anatomy labs, with cadavers, biochemistry, and physiology labs, i was blown away.

Now what you learn at some of these fancy campuses is another story....

CARICOM-MED
08-27-2010, 12:06 AM
CHIROPRACTIC COLLEGES:
Canadian Memorial Chiropractic College - CMCC Campus Tour (http://www.cmcc.ca/Page.aspx?pid=299)
YouTube- Canadian Memorial Chiropractic College Campus Tour (http://www.youtube.com/watch?v=oFNGRhkuEmE)

Even at CMCC, I found this video, the campus really is impressive and very modern....guess, this is an eye opener for me...the only thing is that the profession needs some "Push" in the right direction ? an "adjustment" perhaps ;) LOL



I want to go to the Parker Museum :lol:

The school that is supposed to be really nice, campus wise, is NYCC. They took over some defunct university, so i guess they have all the room they would ever need and i hear they spend a fortune on facilities and maintenance.

National is getting better. I think they received some massive donations in the last few years and have really been updating the campus. When i first started, the main building looked like a run down grade school and most of the other buildings had a real 1980's feel to them. They have since renovated and expanded the main building, modernizing all of the classrooms and labs. They have also cleaned up the clinic, the dorms, and bought some new property. The only downside is the library, which is still a POS.

Before i started chiropractic school, i was just a shocked to find out how modern and well equipped some of these schools are. When i found out every chiro school had anatomy labs, with cadavers, biochemistry, and physiology labs, i was blown away.

Now what you learn at some of these fancy campuses is another story....

khiro
08-27-2010, 08:22 AM
with the other options (DO and MD) being "real" docs, what would you want the scope of the DCM to be?? just a back doc (DC) that is an expert in the manual therapies, with Rx rights for a few meds (like the OD for the eyes)? as i get older i would like to see and treat other diseases like the most common ones; but i would see the DCM (if he was like the OD), to be a step in the right direction for sure.
and you're right in that the first step is to create a brand new school
but for this school to survive the state laws for the DCM would have to be supportive of the education. which state would accept a DCM school, and legislate accordingly with practice acts to allow the grads to practice what they were taught? no good to be taught things you can't do.



I suppose it is possible but I would imagine such a move would still be decades away. ;)

I think the first sign that is happening is one of these schools finally developing the D.C.M. degree.

CARICOM-MED
08-27-2010, 09:00 AM
Just created this thread with my 2 cents on the issue:
http://www.valuemd.com/chiropractic-schools/201001-chiropractic-diploma-dc-vs-doctor-chiropractic-medicine-dcm.html#post1295643

AgActual
08-27-2010, 09:35 AM
what would you want the scope of the DCM to be?Well I don't actually think it would be necessary to create a DCM degree.The type of added scope that a DCM would provide is already very well covered by medical doctors, especially orthopedists. Why see a chiropractor for pills or surgery, when medical orthopedists could do it all 10,000x better. I think a DCM would lose sight of the non-medical and non-surgical option that chiropractic can provide.

However, i do know at least one school has or once had expressed interest in developing a DCM program and I think if that ever happened, and the states made it a legal scope of practice, then in the years following, those DCM practitioners would receive more and more rights, eventually looking a lot like DO's.

If chiros were to ever become mainstream, medical experts, that would be the route they would take, since the DCM degree has already cleared all of the hurdles in the federal government and would be a huge step in making chiropractic a medical field.



Also, interestingly, NUHS referes to their DC program as DCM (Doctor of Chiropractic Medicine)True but as you probably already guessed, there is no drugs or surgery being used at NUHS. However, I was once told by the dean of the chiropractic college, that they are getting ready to teach the students about how to prescribe pain medication and muscle relaxants, since several states have been considering granting chiropractors the power to prescribe such medication. However, obviously my school grants DC degrees and not DCM degrees. I think the only reason why they call it "chiropractic medicine" is because they like the idea of chiropractors being PCPs.


I know that CMCC/NUHS/SCUH/NWUH/BU are all advocates of evidence based practices....I predict that the profession will be split into two in the near future......and the CMCC/NUHS et al will be similar to the DO Approach, while PALMER/SHERMAN will be more like a MT/RMT approach (Manual-Massage only.)Actually the guy that runs NUHS proposed something a long those lines a few years back. He believes that chiropractors coming from schools like National should branch out and start treating many conditions outside of the MSK system, with scientifically validated non-medical and non-surgical treatments. Chiropractors would still be focused on skeletal treatment but also be well versed in treating other systems in the body, with alternative means, where appropriate.

And schools like Life and Palmer should regress, and focus only on subluxations. However, this idea seemed like a ploy to me, since the president of NUHS does not support the subluxation theory. Maybe trying to convince the crappy schools to become straight chiropractic colleges was a plot to get them shut down by the government or the CCE?

CARICOM-MED
08-30-2010, 04:32 PM
The Rational behind National MSc (ACP)

Perhaps ??
In anycase, I think a two tier profession is long overdue, I've seen DCs that are "subluxation" based, while others are "Evidence Based" or "Mixers"....It is very confusing to the Public to know where to go and to seek what from whom, if standards are not set on a global national scale....
DCM or DC with MSc(ACP) is the wave of the future for Evidence Based DCs....who want to do more than just "Adjust Subluxations" :)


Well I don't actually think it would be necessary to create a DCM degree.The type of added scope that a DCM would provide is already very well covered by medical doctors, especially orthopedists. Why see a chiropractor for pills or surgery, when medical orthopedists could do it all 10,000x better. I think a DCM would lose sight of the non-medical and non-surgical option that chiropractic can provide.

However, i do know at least one school has or once had expressed interest in developing a DCM program and I think if that ever happened, and the states made it a legal scope of practice, then in the years following, those DCM practitioners would receive more and more rights, eventually looking a lot like DO's.

If chiros were to ever become mainstream, medical experts, that would be the route they would take, since the DCM degree has already cleared all of the hurdles in the federal government and would be a huge step in making chiropractic a medical field.


True but as you probably already guessed, there is no drugs or surgery being used at NUHS. However, I was once told by the dean of the chiropractic college, that they are getting ready to teach the students about how to prescribe pain medication and muscle relaxants, since several states have been considering granting chiropractors the power to prescribe such medication. However, obviously my school grants DC degrees and not DCM degrees. I think the only reason why they call it "chiropractic medicine" is because they like the idea of chiropractors being PCPs.

Actually the guy that runs NUHS proposed something a long those lines a few years back. He believes that chiropractors coming from schools like National should branch out and start treating many conditions outside of the MSK system, with scientifically validated non-medical and non-surgical treatments. Chiropractors would still be focused on skeletal treatment but also be well versed in treating other systems in the body, with alternative means, where appropriate.

And schools like Life and Palmer should regress, and focus only on subluxations. However, this idea seemed like a ploy to me, since the president of NUHS does not support the subluxation theory. Maybe trying to convince the crappy schools to become straight chiropractic colleges was a plot to get them shut down by the government or the CCE?

khiro
08-31-2010, 04:41 PM
thats all folks.... personally i don't think that i will live to see the day of the two tier in chiro. i am a little different than most DCs in that i don't believe in the non-drug, non-surg forever approach. but to the true DCs credit there are options thank God, and they correctly point them out often and loudly (MD and DO). i have followed more than a few DCs who practiced and after a while decided to try medicine b/c there was nothing else available within the chiro profession. i haven't heard one word of regret from any of them except that most wished they had started med school sooner. interesting that all of them say that don't regret having done chiro. that is surprising to me, but thats their feelings on the matter. all say (brutally honest) that one of the main reasons they left is the declining reimbursement for chiro procedures, and then of course practice boredom, etc.

i have spoken my thoughts on the industry, and feel that it is very stagnant on the national level, and that there is a tremendous influence from the life, palmer and others that will not support any change in practice scope or procedure. so for the next decade or two my advice is for young people to skip chiropractic. leave it to the lifers to correct hearing loss, diabetes, childhood diseases. it is just a short matter of time before all of this will be exposed. chiro may be denied by most if not all insurances, and thus become a cash only business. good luck with that business model. whatever happens, i am 100% sure that chiro will continue to only see 5-9% of the public. it is amazing that this industry even exists with that low of a market.




The Rational behind National MSc (ACP)

Perhaps ??
In anycase, I think a two tier profession is long overdue, I've seen DCs that are "subluxation" based, while others are "Evidence Based" or "Mixers"....It is very confusing to the Public to know where to go and to seek what from whom, if standards are not set on a global national scale....
DCM or DC with MSc(ACP) is the wave of the future for Evidence Based DCs....who want to do more than just "Adjust Subluxations" :)

CARICOM-MED
08-31-2010, 05:43 PM
INSURANCE VS. CASH PRACTICE
Funnny, MDs including myself are moving AWAY from insurance by offering Botox, Cosmetics procedures, "Natural & Alternative Medicine" etc.....and DCs are trying to cling or hang on to insurance coverage ?? WHY On earth would Chiros want to be covered by Insurance ?? while cash is king :)



thats all folks.... personally i don't think that i will live to see the day of the two tier in chiro. i am a little different than most DCs in that i don't believe in the non-drug, non-surg forever approach. but to the true DCs credit there are options thank God, and they correctly point them out often and loudly (MD and DO). i have followed more than a few DCs who practiced and after a while decided to try medicine b/c there was nothing else available within the chiro profession. i haven't heard one word of regret from any of them except that most wished they had started med school sooner. interesting that all of them say that don't regret having done chiro. that is surprising to me, but thats their feelings on the matter. all say (brutally honest) that one of the main reasons they left is the declining reimbursement for chiro procedures, and then of course practice boredom, etc.

i have spoken my thoughts on the industry, and feel that it is very stagnant on the national level, and that there is a tremendous influence from the life, palmer and others that will not support any change in practice scope or procedure. so for the next decade or two my advice is for young people to skip chiropractic. leave it to the lifers to correct hearing loss, diabetes, childhood diseases. it is just a short matter of time before all of this will be exposed. chiro may be denied by most if not all insurances, and thus become a cash only business. good luck with that business model. whatever happens, i am 100% sure that chiro will continue to only see 5-9% of the public. it is amazing that this industry even exists with that low of a market.

AgActual
08-31-2010, 06:53 PM
, i am 100% sure that chiro will continue to only see 5-9% of the public. it is amazing that this industry even exists with that low of a market.Well those numbers do sound low, i have heard more like 7.5%-10% but then again, is it really much worse than other health care professions? How many people go to the dentist every year? Or the optometrist, or the podiatrist, or a physical therapist, or a clinical psychologist? I can't imagine that over 10% of Americans make visits to the podiatrist. I don't personally know anyone who has ever been to one and yet no one worries about the future of podiatry.

The number of chiros in this country is falling and the percentage of the population utilizing our services is holding steady. It seems like we are in a correction phase, where the number of chiropractors will be ideal for the percentage of the population that actually need us. I think this field is heading towards a more sustainable future, not a less sustainable one. We are past the glut of chiropractors that we had in the 1980's and the numbers in the profession are going to fall to more reasonable levels. I don't see any problem here.

CARICOM-MED
09-01-2010, 02:46 PM
Yes, all true, think if DCs will see 10% of the population and if you have 1 DC/per 2000 population ratio : Very Health Ratio, that will be good for DCs...

In the late 80s some states had 1/200, like Georgia, & California, which was WAY too high, hence many DCs had no job opportunity....some states like FL & GA currently have 1/400 still high ratio for utilization.....once Chiro colleges stop running like DC Factories.....

I remember in the 80s Life College was producting 400-500 DCs per year !!
Unheard of in any medical school, or any other professional school...While the Demand for DCs was shrinking, & insurance/medicare coverage was dropping....



Well those numbers do sound low, i have heard more like 7.5%-10% but then again, is it really much worse than other health care professions? How many people go to the dentist every year? Or the optometrist, or the podiatrist, or a physical therapist, or a clinical psychologist? I can't imagine that over 10% of Americans make visits to the podiatrist. I don't personally know anyone who has ever been to one and yet no one worries about the future of podiatry.

The number of chiros in this country is falling and the percentage of the population utilizing our services is holding steady. It seems like we are in a correction phase, where the number of chiropractors will be ideal for the percentage of the population that actually need us. I think this field is heading towards a more sustainable future, not a less sustainable one. We are past the glut of chiropractors that we had in the 1980's and the numbers in the profession are going to fall to more reasonable levels. I don't see any problem here.







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