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View Full Version : What are the next steps DC's SHOULD take who want change in chiropractic?



thebonecrusher10
04-01-2011, 10:42 PM
The CCE has made changes already in 2011 that support widespread change in our profession. New Mexico is trying hard as well. Not to mention National and Western are always active in this area.

But what do YOU think we should be doing to promote change in our profession towards a more integrated approach? I ask this question in light of the recent CCE changes supporting a more integrated approach. Give some ideas or examples in theory as well as practical ideas that can be implemented relatively easy.

Your opinion is appreciated! Yes, even yours!

AgActual
04-02-2011, 01:10 PM
Well i am a bit short on time right at this second but for now, my recommendation would be to listen to these radio interviews that I have been pushing for the last few weeks. They are with leading experts in chiropractic and largely address the issue of moving chiropractic forward. And considering the stature of some of these chiropractors, these are not opinions that should be taken lightly. They all see major changes coming and I think we in the chiropractic community should really listen to what they are saying.



-Interview with James Winterstein (president of NUHS) on why chiropractors should have prescription privileges and the problems with subluxation theory. It also contains a very weak rebuttal from Gerry Clum, the former president for Life West.

OnTheOtherHand (http://www.ontheotherhand.podbean.com/)

-Interview with a Randy Ferrance DC/MD on the relationship between medical doctors and chiropractors

OnTheOtherHand Blog Archive Ep 17: Randy Ferrance, DC MD, bridging the gap between chiropractic and medicine (http://ontheotherhand.podbean.com/2011/02/02/ep-17-randy-ferrance-dc-md-bridging-the-gap-between-chiropractic-and-medicine/)

-Interview with Ian Paskowsi DC, who runs a spine care clinic at Jordan Hospital. They recently did a study on the cost effectiveness of chiropractic care in general hospitals.

OnTheOtherHand Blog Archive Episode 12: Jordan Hospitals Dr. Ian Paskowski, Medical Back Pain Director on Quality Spine Care (http://ontheotherhand.podbean.com/2010/12/11/episode-12-jordan-hospitals-dr-ian-paskowski-medical-back-pain-director-on-quality-spine-care/)

-Interview with Richard Vincent who has been a chiropractor since the 1950's and has had various leadership positions with in the field. He talks about where chiropractic is heading.

OnTheOtherHand Blog Archive Episode 10: Richard Vincent, DC on sixty years of ethical practice and the future of chiropractic (http://ontheotherhand.podbean.com/2010/11/11/episode-10-richard-vincent-dc-on-sixty-years-of-ethical-practice-and-the-future-of-chiropractic/)

-Interview with Michael Schneider, DC, PhD, on chiropractors becoming primary care physicians for the spine and MSK system.

OnTheOtherHand Blog Archive Episode 3: Dr. Michael Schneider on Primary Spine Care (http://ontheotherhand.podbean.com/2010/10/05/episode-3-dr-michael-schneider-on-primary-spine-care/)

medic300107
04-02-2011, 01:42 PM
personally until the education includes a full pharmacology course, along with the physiology to go with it, then DC should not be prescribing anything. I do think DC's could be useful in the more minor pain management cases, and thus save patient/insurance a boat load on going to a pain specialist. I thought the recent New Mexico thing was actually rebuffed by a few Deans/Presidents of Chiropractic colleges and said basically what I said above. There is not a complete pharmacology course and as such Rx privileges COULD be dangerous. If the education comes to meet what DCs are requesting by all means give it to them. Until then no. Also remember if you start Rx'ing then malpractice will jump up as well.

AgActual
04-02-2011, 06:35 PM
personally until the education includes a full pharmacology course, along with the physiology to go with it,

They already do. At National, students take a 3 hour course in pharmacology, a 3 hour course in medical therapeutics, and 7 hours of botanical medicine. Then the students in the advanced practice program, the requirement to be able to prescribe medication, take 4 hours of clinical pharmacology. We are all taught about pharmacology.

thebonecrusher10
04-02-2011, 07:37 PM
@AgActual: EXCELLENT remarks! What else should be done? How crucial will organization among those like minded DC's be? Who should take the lead on this?

AgActual
04-02-2011, 07:57 PM
@AgActual: EXCELLENT remarks! What else should be done? How crucial will organization among those like minded DC's be? Who should take the lead on this?

Right now a few of the schools tend to work together to move us towards a more responsible and useful field. The presidents of National and Western states went down to New Mexico to argue for expanded prescription rights, and they did so on behalf of at least a few other colleges. The CCE is trying and may have succeeded in overhauling their standards. The changes will have to happen at the colleges and a good number of the chiro schools no longer teach subluxation and focus primarily on primary musculoskeletal care. As students more and more students are taught that and not one of the many variations of the vertebral subluxation, i believe the reforms will just happen. One thing that may keep you going here. National is now the second largest chiropractic school in the country. The second largest school is also the one most active trying to reform the field. Think about where that will leave us in 10, 15, 20 years. Its just a matter of time.

medic300107
04-02-2011, 09:09 PM
They already do. At National, students take a 3 hour course in pharmacology, a 3 hour course in medical therapeutics, and 7 hours of botanical medicine. Then the students in the advanced practice program, the requirement to be able to prescribe medication, take 4 hours of clinical pharmacology. We are all taught about pharmacology.

A full pharmacology course is 60 hrs. I'm talking about to truly know the drugs you are prescribing, and possible interactions with other drugs/naturopathic remedies. It's not enough to know what you are giving them, you need to know everything they are on and exactly how it works and interacts with the bodies physiology and medicine you may want to prescribe. Paramedics get more pharmacology than 7 hrs.

AgActual
04-02-2011, 09:30 PM
A full pharmacology course is 60 hrs. I'm talking about to truly know the drugs you are prescribing, and possible interactions with other drugs/naturopathic remedies. It's not enough to know what you are giving them, you need to know everything they are on and exactly how it works and interacts with the bodies physiology and medicine you may want to prescribe. Paramedics get more pharmacology than 7 hrs.

60 credit hours or class room hours? If you are talking classroom hours, chiropractors get 195 hours and advanced practice chiros get 255.

If you are talking credit hours then 60 is a lot. That is 2 years and 900 classroom hours worth of just pharm courses, which I would be very surprised albeit impressed if that is actually the case for your degree.

medic300107
04-03-2011, 01:12 AM
............

medic300107
04-03-2011, 01:31 AM
60 credit hours or class room hours? If you are talking classroom hours, chiropractors get 195 hours and advanced practice chiros get 255.

If you are talking credit hours then 60 is a lot. That is 2 years and 900 classroom hours worth of just pharm courses, which I would be very surprised albeit impressed if that is actually the case for your degree.

60-80 classroom hours of just pharmacology, plus 2 years of clinicals using medications every day, and minimum 3 years residency. From what I read on the NM laws they only require 90 clinical and classroom hours. Also from what I gather you don't get 195 classroom hours of pharmacology, that is equivalent to just over 12 credits worth of pharm, 4 semesters worth.

Chiropractic School with Doctoral Degee Program - New York Chiropractic Education (http://www.nycc.edu/AcademicPrograms_DCprogram.htm#4) No pharmacology in Basic Sciences

Doctor of Chiropractic - Course List (http://www.txchiro.edu/academics/doctor_of_chiro/CourseDirectoryTemplate.aspx?LanguageCD=en-US&ItemKey=7367&pb=y) 30 hrs of "Toxicology and Pharmacology"

Basic Science and Accelerated Science Courses at Logan College of Chiropractic and University Programs (http://www.logan.edu/SubPages.aspx?pID=23&mhID=148&splpID=5) No Pharmacology

http://uws.edu/Academic_Programs/Doctor_of_Chiropractic/DC_Program_Curriculum.pdf Again only 1 Quarter of Pharmacology

Curriculum - D.C. (http://www.palmer.edu/Palmer/Pages/Curriculum.aspx?id=333&Type=Chiro) No Pharmacology

I tried to pick the best DC schools I could find to prove my point. The training and clinical experience simply isn't there. I could not find any curriculum for Advance Practice DCs anywhere online except what I posted about the NM board requirements. I'm not saying at no point should DC be able to prescribe things like OTCs, Herbal Supplements, and minor pain relief medications. I'm saying from what I could find there isn't enough evidence to convince me yet. If you have some links to different Advanced Practice curricula, I would gladly take a look.

khiro
04-04-2011, 08:15 AM
if chiropractic is to progress then it must adopt the medical model of drugs and surgery; or at the least drugs. even if you do not use them in your practice you would be required to know them as if you did. that would require a tripling of pharm ed. for chiros. certainly doable. and i agree with medic, some sort of residency or clinicals should be required. this is an area that might cause some bottlenecking of students. can the chiro college implement and control clinicals that include an expanded scope of practice. should meet the nursing clinicals at least. so you are talking hospital setting?? rotations at MD/DO offices?? Health clinic?? i see where medic posted that TCC requires 30cr hrs of pharm/tox. that is the same number of cr hr i had in 1984.

random thought:
as a chiropractor how can I support the mantra of no drugs and surgery in my practice but yet accept that by law i am required to refer drug cases to an MD/DO and surgery cases to an MD/DO?? and of course i do refer b/c it is in the best interest of my pt. after you have been in practice a while and recognize that you have the intelligence to manage the health (complete) of your pts but yet you do not have the education, it can wear on you mentally. and of course, for the dcs that go to med school, this is the number one reason why.

medic300107
04-04-2011, 09:53 AM
if chiropractic is to progress then it must adopt the medical model of drugs and surgery; or at the least drugs. even if you do not use them in your practice you would be required to know them as if you did. that would require a tripling of pharm ed. for chiros. certainly doable. and i agree with medic, some sort of residency or clinicals should be required. this is an area that might cause some bottlenecking of students. can the chiro college implement and control clinicals that include an expanded scope of practice. should meet the nursing clinicals at least. so you are talking hospital setting?? rotations at MD/DO offices?? Health clinic?? i see where medic posted that TCC requires 30cr hrs of pharm/tox. that is the same number of cr hr i had in 1984.

random thought:
as a chiropractor how can I support the mantra of no drugs and surgery in my practice but yet accept that by law i am required to refer drug cases to an MD/DO and surgery cases to an MD/DO?? and of course i do refer b/c it is in the best interest of my pt. after you have been in practice a while and recognize that you have the intelligence to manage the health (complete) of your pts but yet you do not have the education, it can wear on you mentally. and of course, for the dcs that go to med school, this is the number one reason why.

Well written. Stuck behind a rock and a hard place. I think in the end it should make one feel better knowing they treated the patient the best they could. Whether that means referring against traditional beliefs or not. I'm happy to see you get that.

NUHS-AUC
04-07-2011, 06:20 PM
I agree, why not have DCs that interested in expanded scope, Residency which will give them Prescriptive rights and even surgery ? Perhaps an Advance chiropractic degree, such as "DCM" Doctor of Chiropractic Medicine ? Same path the Osteopathic Physicians took ? and BTW: DOs still entertain the DOM idea !!
That would resolve much of the frustration between mixers vs. straights for once, straights can remain "Subluxation" Dogmatic, while the mixers can join allopathic medicine, and use manipulation as a modality which it is what it is a MODALITY !! and FYI the word "Subluxation" should be replaced with Hypomobile spinal segment or "Hypomobile Segmental Dysfunction" proper medical terminology :)



if chiropractic is to progress then it must adopt the medical model of drugs and surgery; or at the least drugs. even if you do not use them in your practice you would be required to know them as if you did. that would require a tripling of pharm ed. for chiros. certainly doable. and i agree with medic, some sort of residency or clinicals should be required. this is an area that might cause some bottlenecking of students. can the chiro college implement and control clinicals that include an expanded scope of practice. should meet the nursing clinicals at least. so you are talking hospital setting?? rotations at MD/DO offices?? Health clinic?? i see where medic posted that TCC requires 30cr hrs of pharm/tox. that is the same number of cr hr i had in 1984.

random thought:
as a chiropractor how can I support the mantra of no drugs and surgery in my practice but yet accept that by law i am required to refer drug cases to an MD/DO and surgery cases to an MD/DO?? and of course i do refer b/c it is in the best interest of my pt. after you have been in practice a while and recognize that you have the intelligence to manage the health (complete) of your pts but yet you do not have the education, it can wear on you mentally. and of course, for the dcs that go to med school, this is the number one reason why.







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