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View Full Version : DC/ND : A Good Option For Expanding Chiropratic Scope



AgActual
03-09-2012, 11:42 AM
Despite going to school with many, many naturopathic students, i always thought of naturopathy as glorified nutritionists with a healthy amount of pseudoscience thrown in. However, after a long talk a few months back with one ND student that i highly respect, i learned that this field is far different than i had originally thought. Being from Illinois, i wasn't really exposed to naturopathy until I came to National but i found out that naturopathic physicians are rather well known on the coasts of the US and canada. In fact, the popularity is expanding quite rapidly. Since i started at National about a year and a half ago, several states have legalized naturopathuic practice out east, including New York. But more importantly to those of us medically inclined chiropractic students, NDs have a significantly broader scope of practice. In most states where they are licensed, NDs have medium to broad prescription rights and can perform minor surgery. For example in the state that i want to practice, Oregon, ND formulary is a 5 page long list of medication. And this isn't some long list of botanicals or homeopathic remedies, these are real medications, including antibiotics, vaccinations, oxycodone, SNRIs, benzodiazapene, statins, epinephrine, and really anything that an MD family physician could commonly be prescribing. And as I have said, this is the case in several close to 20 states now.

So what is my point? Well 2 chiropractic schools( that i know of) also have ND programs and allow for dual enrollment in DC and ND programs. In the case at National, a DC student dual enrolling by second year will only have an extra 16 months of schooling to earn the ND. And upon graduation, they will have a scope of practice similar to a DO in about 10 states in this country and a large portion of Canada. But also importantly, unlike just NDs, a DC/ND will have broad insurance coverage.

And for those that already have a DC, National appears to have a two year program for earning an ND based on advanced standing nut i am less certain about that

So, here is a new option for DC students at at least two schools that are interested in prescription rights or who become more interested in internal medicine as time goes on. Instead of dropping out and starting over at medical or osteopathic school, or finishing the DC and then going back or many years to med school, PA school, or NP school, or getting a ACP masters to be able to prescribe half a dozen medications in one state,earning an ND will get you to roughly the same place as a general practice DO in a fraction of the time, for a fraction of the cost.

So this is what i have decided to do. There are elements of the ND program that i dont like, like homeopathy but when i graduate, i will have an extra year of internship under my belt and when i get inti practice, i will be able to do whatever i want.

And for those wondering, i did research how competent NDs are at prescribing and performing minor surgery. I talked to a few of the MDs working at the school, including a DC/MD, all were completely confident that the training is sufficient. I also read some research studies looking at how NDs performed at prescribing, which concluded that they are on par with other fields that have broad prescription rights.

AgActual
03-09-2012, 12:24 PM
Here is a current list of states that allow naturopaths to practice and their prescription rights



Alaska=None
Arizona=Broad
California=Broad with MD oversight
Connecticut=None
District of Columbia=Being revised
Hawaii=Broad
Idaho=None
Kansas=Being revised
Maine=Limited
Minnesota=None
Montana=Broad
New Hampshire=Broad
North Dakota=???
Oregon=Broad
Utah=Medium
Vermont=Medium
Washington=Broad
United States Territories: Puerto Rico and Virgin Islands=None




Just to prove i am not lying, here the list of drugs that ND's can prescribe in Oregon

Board of Naturopathic Medicine Naturopathic Formulary (http://www.oregon.gov/OBNM/Formulary.shtml)


And to prove why going for an masters in ACP is a bad idea, here is what DC's can prescribe in just New Mexico. Notice how many of those things are OTC


A.Hormones for topical, sublingual, oral use
(1) estradiol
(2) progesterone
(3) testosterone
(4) desicated thyroid

B.Muscle relaxers; cyclobenzaprine
C.NSAIDs - prescription strength
(1) ibuprofen
(2) naproxen
D. Prescription medications for topical use
(1) NMDC Ca2 dextromethorphan
(2) NSAIDSs
(a) ketoprofen
(b) piroxicam
(c) naproxen
(d) ibuprofen
(e) diclofenac
(3) muscle relaxers; cyclobenzaprine
(4) sodium chanel antagonist; lidocaine
(5) minerals; magnesium
E. Homeopathics requiring prescription
F. Other substances by injection
(1) sterile water
(2) sterile saline
(3) sarapin or its generic
(4) caffeine
(5) procaine HCL
(6) epinephrine
(7) homeopathic for injection
(8) lidocaine
(9) vitamins
(a) aqueous vitamin A (IM)
(b) ascorbic acid (vitamin C) (sub-Q or IM)
(c) cyanocobalamin (vitamin B12 (sub-Q or IM)
(d) folic acid (sun-Q IM)
(e) hydroxocobalamin (vitamin B12) (IM)
(f) methycobalamin (vitamin B12) (IM)
(g) thiamin (vitamin B1) (IM)
(10) dextrose (with additional chiropractic board approved education)
(11) phenol (with additional chiropractic board approved education)
(12) autologous blood (with additional medical board approved education)
(13) collagenase (with additional medical board approved education)
(14) glucosamine (with additional medical board approved education)
(15) glycerin (with additional medical board approved education)
(16) platelet rich plasma (with additional chiropractic board approved education)
(17) sodium morrhaute (with addition medical board approved education)
(18) sodium hyaluronate (with addition medical board approved education)



And I can think of a few reasons why getting a DC/ND is better than just an ND. DC's are covered by insurance companies, ND's typically are not. DC's get much more training in MSK diagnosis and treatment, which is one of the most common reasons people go to the doctor. And i think most of us would agree, DC's are quite good at treating such conditions. Chiropractors are licensed in 50 states, ND's in 16, so much more freedom to move around, if needed. And chiropractors have a much higher average salary than ND's.

canuckdc
03-09-2012, 01:55 PM
Just punt and go back to medical school, seems like your trying to justify yourself to much...

AgActual
03-09-2012, 03:20 PM
Seems like your trying to justify yourself to much...

I believe chiropractors should have full prescriptive rights, treat wounds, be able to act as full primary care for internal disorders, if needed; this is stuff I have been saying for years on this forum, since before i even started chiropractic school. And I have been saying that if the field wants to drag its feet on such issues that people interested in practicing in a more medical capacity, should look at outside options, such as earning an NP or PA. Or now we know, an ND, which seems to be a very good option for those that can go down that route. Why not share this info with people that are interested? No justifying, this is the same stuff i have been saying for 3 years. I finally just found an option that is right for me.

And as a DC, you should know there is so much that you are going to learn at a place like National that you won't learn while getting your MD or DO. I want to know that stuff, I want to practice that stuff, med school wouldn't get me there. Full prescriptive rights and the ability to perform surgery adds more tools to my practice that i can use to help my patients. The more you know and the more you can do, the better you will be as a doctor. That is what I want to be. Pull together every treatment modality, whether it is manipulation, rehab, massage, nutrition, exercise, medication, minor surgery, to help people. That is what I want out of life. And if you don't like it then you can deal with it.

NUHS-AUC
03-13-2012, 07:59 AM
PLEASE !!!
Stop with the nonsense....and go to either a real medical school or a PA school....don't waste your 2 years on getting a ND Degree...most states don't even license NDs, and the ones that do, PA is still a much better option.....(for 2 years.)




Despite going to school with many, many naturopathic students, i always thought of naturopathy as glorified nutritionists with a healthy amount of pseudoscience thrown in. However, after a long talk a few months back with one ND student that i highly respect, i learned that this field is far different than i had originally thought. Being from Illinois, i wasn't really exposed to naturopathy until I came to National but i found out that naturopathic physicians are rather well known on the coasts of the US and canada. In fact, the popularity is expanding quite rapidly. Since i started at National about a year and a half ago, several states have legalized naturopathuic practice out east, including New York. But more importantly to those of us medically inclined chiropractic students, NDs have a significantly broader scope of practice. In most states where they are licensed, NDs have medium to broad prescription rights and can perform minor surgery. For example in the state that i want to practice, Oregon, ND formulary is a 5 page long list of medication. And this isn't some long list of botanicals or homeopathic remedies, these are real medications, including antibiotics, vaccinations, oxycodone, SNRIs, benzodiazapene, statins, epinephrine, and really anything that an MD family physician could commonly be prescribing. And as I have said, this is the case in several close to 20 states now.

So what is my point? Well 2 chiropractic schools( that i know of) also have ND programs and allow for dual enrollment in DC and ND programs. In the case at National, a DC student dual enrolling by second year will only have an extra 16 months of schooling to earn the ND. And upon graduation, they will have a scope of practice similar to a DO in about 10 states in this country and a large portion of Canada. But also importantly, unlike just NDs, a DC/ND will have broad insurance coverage.

And for those that already have a DC, National appears to have a two year program for earning an ND based on advanced standing nut i am less certain about that

So, here is a new option for DC students at at least two schools that are interested in prescription rights or who become more interested in internal medicine as time goes on. Instead of dropping out and starting over at medical or osteopathic school, or finishing the DC and then going back or many years to med school, PA school, or NP school, or getting a ACP masters to be able to prescribe half a dozen medications in one state,earning an ND will get you to roughly the same place as a general practice DO in a fraction of the time, for a fraction of the cost.

So this is what i have decided to do. There are elements of the ND program that i dont like, like homeopathy but when i graduate, i will have an extra year of internship under my belt and when i get inti practice, i will be able to do whatever i want.

And for those wondering, i did research how competent NDs are at prescribing and performing minor surgery. I talked to a few of the MDs working at the school, including a DC/MD, all were completely confident that the training is sufficient. I also read some research studies looking at how NDs performed at prescribing, which concluded that they are on par with other fields that have broad prescription rights.

7125
03-13-2012, 02:26 PM
I agree with NUHS-AUC. Your goal should be geared toward working within the mainstream health care profession as opposed to away from it.

AgActual
03-13-2012, 06:43 PM
PLEASE !!!
Stop with the nonsense....and go to either a real medical school or a PA school....don't waste your 2 years on getting a ND Degree...most states don't even license NDs, and the ones that do, PA is still a much better option.....(for 2 years.)

One extra year, not two. And what "nonsense" are you talking about? Wheres the problem? What am I doing that is so wrong? Enlighten me as to why i should become a lackey of an MD or why i should panic, abandon my career, and flee to the Caribbean?

You said a few months ago that DC's should have prescriptive rights and a DC with prescriptive rights would be a worthwhile thing. So that is what I am going to be, just one extra year in school and a nearly free second doctorate but now that is not good enough. Now I have to be an MD. If you aren't an MD, you're nothing. Well I would rather be outside of the mainstream, in a nothing career than become another arrogant, rude, dismissive medical doctor.

7125
03-13-2012, 09:04 PM
One extra year, not two. And what "nonsense" are you talking about? Wheres the problem? What am I doing that is so wrong? Enlighten me as to why i should become a lackey of an MD or why i should panic, abandon my career, and flee to the Caribbean?

You said a few months ago that DC's should have prescriptive rights and a DC with prescriptive rights would be a worthwhile thing. So that is what I am going to be, just one extra year in school and a nearly free second doctorate but now that is not good enough. Now I have to be an MD. If you aren't an MD, you're nothing. Well I would rather be outside of the mainstream, in a nothing career than become another arrogant, rude, dismissive medical doctor.

Good luck man.

axiomofchoice
03-13-2012, 09:10 PM
If it looks like a duck, walks like a duck, and quacks like a duck.... its probably a DC/ND

AgActual
03-13-2012, 09:56 PM
If it looks like a duck, walks like a duck, and quacks like a duck.... its probably a DC/ND

Shhhhh, the adults are trying to talk.

canuckdc
03-14-2012, 05:59 AM
you will never change what chiropractic is, good or bad. Its taken a century to define itself and its still really not that clear. There is truth in saying that you learn things in chiro school that you wont learn anywhere else, but school is not the real world. The scope of practice that you would like will never happen as there is to much internal conflict with our chiropractic legislators. There are still plenty of old school chiros that just want to do manual therapies and this is aside from their philosophical standing. At State or Provincial level Ive seen these arguments spinning wheels for years. More often changing scope of practice and redefining or expanding it gets squashed at the association or College level before even making it to government. We also haven't won any popularity contests lately with our health care allies and they are alot bigger than us.... In the end nothing ever happens and we just keep adjusting...
If you want to be a chiro MD with your training, move to south america where in some countries they will let you do anything and have the same rights as a qualified MD. or if your young (or old) and you want to practice in N. America, bite the bullet and go to med school. you will save yourself alot of frustration

khiro
03-14-2012, 11:27 AM
i side, of course, with canuckdc for most people in that he has nailed the current state of chiro with its unclear mandate, education and legislative woes. i have never recommended chiro for a job b/c of these reasons, and not so much on what chiros do. however agactual brings up a good pt of expanded scope in oregon through the ND. good for him to be thinking in this direction (expanded scope). now he can't come to florida to flee those cold winds and do ND b/c florida quit giving out ND licenses (can we all say Fl Medical Assoc). but if it works in oregon, and that is where he wants to practice then investigate and if it helps your practice as well as your pocket then do it.

NUHS-AUC
03-15-2012, 02:24 PM
PA or NP are much better choice, don't get me wrong, I'm all for NDs and what they do....HOWEVER, most states don't license them, most insurance companies don't cover them, and most physicians don't collaborate or refer to them....so why even bother ?
You will spend your ND internship sitting around at the "Cafeteria" waiting to see ONE patient if you are lucky...trust me I know from some of my DC colleagues that chose this path instead of MD/DO/PA.

Better invest your time and $$$ wisely....as a PA you can work in a group practice, making good $$$, and low malpractice, and it is only 2 years, in comparison to 2 years of ND program for DC....

Good luck !

khiro
03-16-2012, 10:16 AM
good pts as usual from NUHS-AUC. i have no info on how much $$ one could add to a DC practice using ND. i agree that the PA and NP degrees for most people will be much more beneficial. i especially like your sentence "better invest your time and $$ wisely". this is so impt. remember the saying "measure twice, cut once". good advice for making any decision.

AgActual
03-16-2012, 11:29 AM
Most states don't license them

But I am going to practice in Oregon, so that isn't a problem for me.


most insurance companies don't cover them

True but they do cover a DC and I will have that too, so not really a big deal. I talked to my dad, who has worked at blue cross for 25 years and he said I can just bill under the DC for any general medicine diagnosis and treatments. Remember, Oregon has extremely liberal chiropractic laws, they can even perform minor surgery, so everything except writing a prescription will be billable where I am going. And my patients will be able to get insurance coverage at any pharmacies that they use, so that isn't a problem either.


most physicians don't collaborate or refer to them....so why even bother

Again, having a DC as well could help with that. However, if I have a broader scope, there will be less reason to lean on medical doctors, so why does it matter? If an MD doesn't want to talk to me then I can just do things myself. Adding the ND to a DC should provide more freedom to me, not less. And NDs are pretty well established where i am going, so an MD, DO, DPM, etc should be more likely to talk to me than in states where NDs are not well known.


Yes, you are right, certain people would not be able to use this path. If you are planning on practicing in a state like Texas, where you can't practice as an ND, being a DC/ND would be no better than being just a DC. But states like Oregon, Washington, California, Arizona, where NDs can practice and are well established, getting that extra ND might make something to consider.



You will spend your ND internship sitting around at the "Cafeteria" waiting to see ONE patient if you are lucky

Things have changed in the 9 years since you were an intern. I can work at many different internship sites, including hospitals and that is what I plan on doing.


it is only 2 years, in comparison to 2 years of ND program for DC

One year.

NUHS-AUC
03-17-2012, 09:22 AM
Corrections:

1. Duration: if you review NUHS website, it is 4 at LEAST semesters for DCs to get their ND, (Just ask Dr. Black :)...) 4 semesters are 2 academic years !
if you already pursuing 2 academic years, my recommendation holds...

2. Clinicals: Which hospitals is NUHS affiliated with ? for Naturopathy ? NDs are NOT licensed in Illinois, so, please provide me with a name of ANY hospital that will have NDs intern do rotations :) NDs in IL work as "health consultant" NOT doctors, if anything NDs rotate under the MD NUHS just hired.

3. Collaboration: Why on earth would you want to isolate yourself, as a DC/ND where as a PA you are part of a team (mainstream), covered by insurance, work with MDs, have a GREAT salary, and can actually pay your student loans in 2-3 years...

4. Time Invested: as a ND you will learn and waste time on "unproved" therapies, (hydrotherapy, homeopathy etc...) this time you should invest in reviewing pathology, pharmacology, and all branches of medicine, something you CAN NEVER get at ANY integrative university. Question: wouldn't you rather spend time rotating with a general surgeon, learning about all new procedures, versus learning about a 200 year old "Homeopathy" that is UNPROVEN, does NOT work, and useless ??? or learn how to tell patients to take a hot-cold contrast shower or do "skin brushing" LOL, something they can simply Google on their own ?? :) (Yes, I I've talked to a frustrated ND graduate that is in debt and has no job opportunities.)

Best wishes to you, and please pass on my regards to everyone at National :)

AgActual
03-17-2012, 11:40 AM
I am currently typing on my phone, so no ling reply right now but I go to school during the summer so fore trimesters is a year plus four months, so about a year. Dr. Black is taking longer than 1 year because she already had her DC when she started. That takes longer than if you dual enroll. Plus she teaches and has a chiropractic practice, so she went through the ND program at a much slower pace.

And you can intern as an ND in Illinois , so you can work in hospitals. The specific one that I know about in Illinois, off the top of my head is a hospital with a cancer treatment center in Zion and soon Elmhurst hospital. There is a list of hospitals around the country where National interns can go on the schools website. There are also some MDs that have clinics where national ND interns can practice at

NUHS-AUC
03-17-2012, 06:42 PM
LOL, whatever, good luck to you then, you're not making a wise decision, it is your $$$ and your time, that you won't get back...

Regards,

AgActual
03-17-2012, 09:49 PM
LOL, whatever, good luck to you then, you're not making a wise decision, it is your $$$ and your time, that you won't get back...

Regards,


Well thats rude

canuckdc
03-19-2012, 01:09 AM
Ag

Go for it if your really want to be an ND (Really), but dont expect much integration past your training. get ready for years of solitude practice and being stereotyped. You talk about hospitals, interns etc terms that wanna be medical docs use, but the general public will always view you as that alternative doctor or not a real doc. If your happy living on the fringe and your heart and soul is truly aimed at Naturopathic medicine great! there is money to be made in all these professions. If you want to fit into the status quo, have society pat you on the back...go back to Med school

NUHS-AUC
03-20-2012, 04:17 PM
Plus 99% of MDs have no idea what it takes to be an ND, most think you can get it after few months online....best bet for the time and $$$ is either PA or NP if you don't want to go back to MD/DO...
http://www.valuemd.com/chiropractic-schools/223075-dc-pa-option-expanded-scope.html#post1438397







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