I Got 99 Problems and Chiropractors are One

[GeminiPA34]

I've worked in Integrated Physical Medicine for 3.5 yrs now. The offices are co-owned by an MD and a Chiropractor and I make $115K/yr.  My questions are......

 

Has anyone worked with a Chiropractor who tends to over step his/ boundaries regarding medical patient care?

 

Does the Chiro have a difficult time understanding that he/she is not your boss but you are colleagues? 

 

Have you ever instructed the staff to do one thing (medically related) and the Chiro goes behind your back and instructs the staff to do the opposite of what you said? I understand I do not sign their checks, but I am the Health Care Provider in the office. 

 

Have you ever felt as if the Chiro cares more about what services and which DMEs can be billed and how much money can be made from the patient vs what the patient actually needs. 

 

I've had similar experiences in 3 different offices and yes I've had to get the Supervising Physician involved a few times. 

l really enjoy Physical Medicine but I do not think I can work with a Chiropractor any longer. Has anyone else had these type of experiences. 

[LKPAC]

I don't think I would allow myself to be in that position.  Chiros lose me when they say they can cure infections with "adjustments" or that babies need to be "tuned up."  These are their words not mine.  I am a scientist.  Chiros are not.

[Guest Paula]

My only experience with chiropractors (other than my dad who retired 20 years ago and was the best physical therapist in town) is the one who was hired at a previous clinic I worked at.  The treatments were 15 seconds long and every single person had full spine X-rays and EVERY SINGLE PERSON had the exact same diagnosis (crooked spine, elevated hip on one side).  All patients had to have twice weekly adjustments for the rest of their life, and quickly used up their insurance maximum for chiro, PT and OT visits.  Unfortunately, when the patient really needed PT they had nearly used all their insurance on chiro.  

 

I was not involved in hiring the chiro.  I was not in favor of hiring.  I felt like I was obligated to refer to chiro and did a few times, then stopped and did my usual referrals to PT or physiatry and physical medicine and rehab. The situation was one of the reasons why I left the job.  The patients thought the chiro was a doctor (he is, doctor of chiropractic) but could not understand why he couldn't prescribe.  I did not take his advice when the chiro asked me to prescribe for him.....nope, I told him the patient had to see me in follow up if he felt the pt. needed a prescription medication. It was a strange and weird situation that the medical director and health director thought would be a good idea, along with them hiring a pediatrician to see adult patients in urgent care.  That was the last straw and I resigned about 3 months after that.  I could tell you stories those last 3 months.....but I won't.  PTSD will set in again. 

 

P.S. the chiro read all his own X-rays.  I would go back and re-read them myself and sent a few off to the rads who we contracted with...none of whom read the X-rays as crooked spine and elevated hips. 

[Joelseff]

Another dx they love is "Subluxated rib"

 

Sent from my S5 Active...Like you care...

 

 

[RealityCheck]

I have never worked "with" a chiropractor because we simply do not speak the language or seem to understand the human body in the same way.

Chiropractors have never communicated with any of the PAs or MDs or DOs I have worked with in either Texas or Washington - nothing collegial.

I too am appalled by adjustments forever and ever, amen and the ever present leg length discrepancy and abnormal spinal curvature and those pesky ribs that keep coming out......

One of my weirdest families was led by a DC dad with 6 unvaccinated kids whom he adjusted DAILY since birth but all his kids were on State Ins because he wasn't a successful chiropractor. They were first to call with any sneeze, cough, etc and wanted Kenalog injections YEARLY for everyone because allergies were just too tedious to cope with. Absolute hypocrisy in action.

 

As for the original post - professional integrity is priceless and if you are working in a situation where billing supercedes medical decision making and appropriate delivery of medical treatment then --- can you stay there and not risk your professional integrity? You are not comfortable with the interactions and subversive actions and it could ultimately harm a patient. It sounds as though the SP and other docs are not willing to intervene. Easier to say than do - look at what you can change and what it will take and decide its worth versus your integrity and happiness and fulfillment at work.

 

Let us know how it works out.

 

My 2 cents....

[GeminiPA34]

  The treatments were 15 seconds long and every single person had full spine X-rays and EVERY SINGLE PERSON had the exact same diagnosis (crooked spine, elevated hip on one side).  All patients had to have twice weekly adjustments for the rest of their life, and quickly used up their insurance maximum for chiro, PT and OT visits.  Unfortunately, when the patient really needed PT they had nearly used all their insurance on chiro.  

 

Ok now I am a believer. The Chiros tell EVERY PATIENT they have a crooked spine and an elevated hip. GEESH... This can't be real. 

[GeminiPA34]

 

As for the original post - professional integrity is priceless and if you are working in a situation where billing supercedes medical decision making and appropriate delivery of medical treatment then --- can you stay there and not risk your professional integrity? You are not comfortable with the interactions and subversive actions and it could ultimately harm a patient. It sounds as though the SP and other docs are not willing to intervene. Easier to say than do - look at what you can change and what it will take and decide its worth versus your integrity and happiness and fulfillment at work.

 

Let us know how it works out.

 

My 2 cents....

  Professional integrity is not a battle for me its the constantly having to explain why X,Y,Z does NOT need to be done. I have decided to move on at the end of year because as you stated happiness and sense of fulfillment are extremely important to me. Definitely words to think about. Thank You. 

[True Anomaly]

Have a friend who's brother-in-law is a chiro.  Said friend had a child, and at 3 months of age his wife posted photos of "Baby's first adjustment" with her brother the chiro doing the spinal adjustments.  On a 3 month old.  3 MONTHS OLD.  

 

I can't, in good conscience, support that.

[GetMeOuttaThisMess]

Back in the early 80s my spine group contracted with a local chiropractor. We would refer cases to him that had received maximum medical/surgical care from our group. I never had the impression that he was out in left field and we actually had several patients that reported moderate to significant improvement. That being said, I have never seen one personally, and frankly don't know that I could relax enough to even allow for an adjustment.

[BruceBanner]

Their "profession" is so rooted in pseudoscience and physiological fallacies that I just cant get on board with them. That and their educational accreditation is suspect at best.

 

That said, I used to refer to one all the time when I was in Occ Med, but this was more of a "placebo" referral. I sent patients there who had no clinical or radiologic evidence of a true anatomical problem, but continued to have back pain. About half of them improved, the other half did not and he discharged them after about 6 visits. He was reasonable.

[sas5814]

I've worked in Integrated Physical Medicine for 3.5 yrs now. The offices are co-owned by an MD and a Chiropractor and I make $115K/yr.  My questions are......

 

Has anyone worked with a Chiropractor who tends to over step his/ boundaries regarding medical patient care?

 

Does the Chiro have a difficult time understanding that he/she is not your boss but you are colleagues? 

 

Have you ever instructed the staff to do one thing (medically related) and the Chiro goes behind your back and instructs the staff to do the opposite of what you said? I understand I do not sign their checks, but I am the Health Care Provider in the office. 

 

Have you ever felt as if the Chiro cares more about what services and which DMEs can be billed and how much money can be made from the patient vs what the patient actually needs. 

 

I've had similar experiences in 3 different offices and yes I've had to get the Supervising Physician involved a few times. 

l really enjoy Physical Medicine but I do not think I can work with a Chiropractor any longer. Has anyone else had these type of experiences. 

Its tough to try and keep the peace and follow good science in this circumstance. I think you would have to decide between driving a stake in the ground and calling BS BS or moving on. I'd have a calm discussion with the physician and explain your concerns and then, if you don't get satisfaction, move on. I have a whole spittle flecked rant about Chiro's but I'll spare you the experience. :-)

[GeminiPA34]

Its tough to try and keep the peace and follow good science in this circumstance. I think you would have to decide between driving a stake in the ground and calling BS BS or moving on. I'd have a calm discussion with the physician and explain your concerns and then, if you don't get satisfaction, move on. I have a whole spittle flecked rant about Chiro's but I'll spare you the experience. 

 

I so over calling "BS" and will move on the end of the year. This is LAST job I will take working along side a Chiro. The post on this thread have confirmed my suspicion. I personally would love to hear your Chiro rant. 

[GeminiPA34]

Have a friend who's brother-in-law is a chiro.  Said friend had a child, and at 3 months of age his wife posted photos of "Baby's first adjustment" with her brother the chiro doing the spinal adjustments.  On a 3 month old.  3 MONTHS OLD.  

 

I can't, in good conscience, support that.

Wow you have to be kidding me!!!  A 3month old? I thought telling a patient they need an adjustment 5days / week was bad. Geesh that takes the cake. 

[delco714]

What about OMM? I let my doc do mild adjustments to c and t spine when all the other stuff won't fix it..maybe twice a year

[Boatswain2PA]

What about OMM? I let my doc do mild adjustments to c and t spine when all the other stuff won't fix it..maybe twice a year

I don't know if there is any (actual) science in OMM, but I don't think anyone disputes that it can be effective.  

 

So the question is who do you refer your patients to for OMM?  I try to send my patients to a DO who does OMM because they are the best of both worlds (ie: they practice medicine AND they do OMM).  I go to a DO who does a good job on my wrecked back and neck and I get better results than I can get on my with with stretching, exercises, mobic or ibuprofen, ice, and lidocaine patches.

 

Here's my Chiropractor rant:  

 

There are some good Chiropractors.  They are the one who may put a heat pack on you, then they come in, feel up and down your spine/joints, and then do a manipulation.  They also know their limits; they know they can't fix your "sinus infection" by manipulating your facial lymph nodes, or your infertility by adjusting your little toe.  

 

But if you walk into a chiropractor office and see the "wall of shame" in the lobby....the entire wall of overpriced supplements, vitamins, and minerals, then run out the door because the same things are 1/10th the price at wal-mart, and the chiropractor is a quack.

 

If you walk in and the first thing the chiropractor wants to do is take an x-ray of your back, then run out the door because the chiropractor doesn't have a clue how to read an X-ray. 

 

 

[problem child]

I've worked in Integrated Physical Medicine for 3.5 yrs now. The offices are co-owned by an MD and a Chiropractor and I make $115K/yr.  My questions are......

 

Has anyone worked with a Chiropractor who tends to over step his/ boundaries regarding medical patient care?

 

Does the Chiro have a difficult time understanding that he/she is not your boss but you are colleagues? 

 

Have you ever instructed the staff to do one thing (medically related) and the Chiro goes behind your back and instructs the staff to do the opposite of what you said? I understand I do not sign their checks, but I am the Health Care Provider in the office. 

 

Have you ever felt as if the Chiro cares more about what services and which DMEs can be billed and how much money can be made from the patient vs what the patient actually needs. 

 

I've had similar experiences in 3 different offices and yes I've had to get the Supervising Physician involved a few times. 

l really enjoy Physical Medicine but I do not think I can work with a Chiropractor any longer. Has anyone else had these type of experiences. 

 

I'm having this kind of problem with my dept. chief, and he's an MD. along with general harassment and bullying which has resulted in my having to take a medical leave. the last incident with him was so abusive it left me virtually short-circuited. I haven't been the same since, and for the following 3 weeks after that stellar moment(s), my ability to focus on my work and take care of my patients has been so negatively impacted that I can't even hold a pen without it shaking out of my hand. thus the medical leave. I am getting HR and the CMO involved.

 

and isn't it just like me (a dedicated PA, could be any of us) to feel guilty for taking action to take care of myself!?!

pls pray for me..... :-(

[GeminiPA34]

I'm having this kind of problem with my dept. chief, and he's an MD. along with general harassment and bullying which has resulted in my having to take a medical leave. the last incident with him was so abusive it left me virtually short-circuited. I haven't been the same since, and for the following 3 weeks after that stellar moment(s), my ability to focus on my work and take care of my patients has been so negatively impacted that I can't even hold a pen without it shaking out of my hand. thus the medical leave. I am getting HR and the CMO involved.

 

and isn't it just like me (a dedicated PA, could be any of us) to feel guilty for taking action to take care of myself!?!

pls pray for me..... :-(

Someone once told me always remember YOU are the PA!! Never feel bad for taking action to protect yourself because even the MD's will through you under the bus to protect themselves. My problem is I'm tired of taking action and having to say NO soely because these clowns just want to bill for as much as they can. Dealing with things like this is the ugly side of medicine where more of a business versus taking care of the patients. Take care of yourself my friend and prayers are with you.  

[GeminiPA34]

There are some good Chiropractors.  They are the one who may put a heat pack on you, then they come in, feel up and down your spine/joints, and then do a manipulation.  They also know their limits; they know they can't fix your "sinus infection" by manipulating your facial lymph nodes, or your infertility by adjusting your little toe.  

 

But if you walk into a chiropractor office and see the "wall of shame" in the lobby....the entire wall of overpriced supplements, vitamins, and minerals, then run out the door because the same things are 1/10th the price at wal-mart, and the chiropractor is a quack.

 

If you walk in and the first thing the chiropractor wants to do is take an x-ray of your back, then run out the door because the chiropractor doesn't have a clue how to read an X-ray. 

 

 

Agree 100% 

[delco714]

I don't know if there is any (actual) science in OMM, but I don't think anyone disputes that it can be effective.

 

So the question is who do you refer your patients to for OMM? I try to send my patients to a DO who does OMM because they are the best of both worlds (ie: they practice medicine AND they do OMM). I go to a DO who does a good job on my wrecked back and neck and I get better results than I can get on my with with stretching, exercises, mobic or ibuprofen, ice, and lidocaine patches.

 

Here's my Chiropractor rant:

 

There are some good Chiropractors. They are the one who may put a heat pack on you, then they come in, feel up and down your spine/joints, and then do a manipulation. They also know their limits; they know they can't fix your "sinus infection" by manipulating your facial lymph nodes, or your infertility by adjusting your little toe.

 

But if you walk into a chiropractor office and see the "wall of shame" in the lobby....the entire wall of overpriced supplements, vitamins, and minerals, then run out the door because the same things are 1/10th the price at wal-mart, and the chiropractor is a quack.

 

If you walk in and the first thing the chiropractor wants to do is take an x-ray of your back, then run out the door because the chiropractor doesn't have a clue how to read an X-ray.

 

 

Well put. I agree

[whoRyou]

Have a friend who's brother-in-law is a chiro.  Said friend had a child, and at 3 months of age his wife posted photos of "Baby's first adjustment" with her brother the chiro doing the spinal adjustments.  On a 3 month old.  3 MONTHS OLD.  

 

I can't, in good conscience, support that.

OK, that bothers me ... I am not sure how others feel, but to me that is just weird and someone needs to stop this type of abuse! 

[whoRyou]

In any profession, there are some good ones and then there are some shady ones. 

 

EDIT: BTW, I just found this ... Here is a video demonstrating a chiropractic exam and spinal adjustment of a baby that is supposedly 5 hours old. I will go ahead and let you know that there is absolutely, under no circumstances, any indication to hold a baby up in the air by one leg to see which way their head turns. He just keeps doing it until the kid happens to look the other way and then claims to have successfully corrected the pressure on the baby’s brainstem.

 

[delco714]

In any profession, there are some good ones and then there are some shady ones.

 

EDIT: BTW, I just found this ... Here is a video demonstrating a chiropractic exam and spinal adjustment of a baby that is supposedly 5 hours old. I will go ahead and let you know that there is absolutely, under no circumstances, any indication to hold a baby up in the air by one leg to see which way their head turns. He just keeps doing it until the kid happens to look the other way and then claims to have successfully corrected the pressure on the baby’s brainstem.

Makes me want to vomit. This is appalling, dangerous and makes me viscerally upset and angry

[RealityCheck]

It is also very common in Eastern Indian Medicine to have a healer - usually an elderly female - present at birth and she adjusts the baby's chakras by holding it upside down and kind of flipping it like an omelet.

 

My weird patient manipulated each of his 6 unvaccinated children DAILY from birth. One has severe Aspergers and the others just aren't quite right. They also home school, don't vaccinate and believe that daily manipulations are needed to keep the body centered. Kind of curious how much traction he put on the kids' spinal columns and brainstems during those crucial developmental years…….

 

We have had local chiros telling parents they can fix allergies and ear infections with adjustments and there are at least 2 chiros in town who hold "special certification" in Sports Medicine and want to work on ADOLESCENTS by doing adjustments and helping them with strengthening and core training. One of my kid's soccer coach tried to force us into paying $110 for the players to "participate" in the training. The coach knows what I do for a living and I made it painfully and rather verbally clear that under no circumstances would a chiropractor be touching any member of my family and particularly NEVER one with open growth plates and those pesky nerve roots in the neck and spine. He was appalled that I wouldn't incorporate "complementary" medicine into my family's healthcare. I hung up……. My kid moved to a new club for soccer.

 

I too am appalled at the scope and breadth of their stretch with little to no scientific backing or logic. I find it strange that people will come to me demanding a pill for everything and would still trust someone to violently thrust their neck and "cure" them. Seems contradictory at best.

 

I will keep fighting the good fight for my patients to receive sound medical care. The battle rages on…..

[MedicinePower]

Have a friend who's brother-in-law is a chiro.  Said friend had a child, and at 3 months of age his wife posted photos of "Baby's first adjustment" with her brother the chiro doing the spinal adjustments.  On a 3 month old.  3 MONTHS OLD.  

 

I can't, in good conscience, support that.

http://www.smh.com.au/national/health/call-for-age-limit-after-chiropractor-breaks-babys-neck-20130928-2ul6e.html

 

Call for age limit after chiropractor breaks baby's neck

Date September 29, 2013

[rev ronin]

I've said it in other threads, but if I were going to recommend any sort of manipulation, I would opt for DO applied OMM over chiropractic any day of the week.  This kind of reinforces that.