Guest guest Posted January 21, 2008 Report Share Posted January 21, 2008 I don't know about your state, but in Wisconsin, a DC is considered a primary care physician, and can refer to PT for all patients except Medicare generally. Hope this helps. Adam Jeschke Optimal Physical Therapy, LLC Lake Mills, WI > > Hello group, we are a small town hospital with three chiropractic clinics > in town. We have recently seen an increase in referrals from chiropractic > offices. In the past we have not allowed these and need a referral from a > family doc to treat. We have found that most of these patients will not go > to the family doc and are just staying with the chiropractors. We would like > to be able to see these patients and do not want to exclude a referral > source. Our policy at the hosiptal is that every pateint needs to have a > doctors referral to be seen. I would like to see these patients but unsure > how to go about doing this? Secondary to liability issues and payment issues > for multiple insurances, do anyone have a good solutions or ideas how to fix > this problem? thanks for the help > > Jeff Nolder, PT > Director of Physical Medicine and Rehab > Cherokee Regional Medical Center > > __________________________________________________________ > Climb to the top of the charts! Play the word scramble challenge with star > power. > http://club.live.com/star_shuffle.aspx?icid=starshuffle_wlmailtextlink_jan > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 21, 2008 Report Share Posted January 21, 2008 Jeff, Unless your state practice act precludes you accepting a referral from a chiropractor, this sounds like it needs to be addressed through the hospital. Hospitals allow for privileges at various levels to include admitting, consultation etc. You may want to check in with your Medical Staff office and determine from that starting point if the hospital is willing to entertain allowing chiropractors privileges. Bear in mind that if they are it will come to vote in committee; and physicians, if they are not inclined to cooperate, could block it. Hospital administration needs to be on board and lobby for the change. M. Cowan Camas, WA > > Hello group, we are a small town hospital with three chiropractic clinics > in town. We have recently seen an increase in referrals from chiropractic > offices. In the past we have not allowed these and need a referral from a > family doc to treat. We have found that most of these patients will not go > to the family doc and are just staying with the chiropractors. We would like > to be able to see these patients and do not want to exclude a referral > source. Our policy at the hosiptal is that every pateint needs to have a > doctors referral to be seen. I would like to see these patients but unsure > how to go about doing this? Secondary to liability issues and payment issues > for multiple insurances, do anyone have a good solutions or ideas how to fix > this problem? thanks for the help > > Jeff Nolder, PT > Director of Physical Medicine and Rehab > Cherokee Regional Medical Center > > __________________________________________________________ > Climb to the top of the charts! Play the word scramble challenge with star > power. > http://club.live.com/star_shuffle.aspx?icid=starshuffle_wlmailtextlink_jan > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 21, 2008 Report Share Posted January 21, 2008 Jeff, The Illinios Physical Therapy Assoc. states that our Practice Act allows for PT's to eval/treat from Chiropractic referrals. This has been all that we have needed to see these patients in our hospital system. As far as the reimbursement issue there have been so few that I have not gotten word from our business office as to not having coverage. The one thing I have been most concerned about is the dual treatment of our service and the chiropractors treatment. My personal experience is that this has not been very successful. I have found more often than not that my plan of care has been altered, added too, or negated. Take this for what it is worth. Jeff Brown PT Director of Rehabilitation Decatur Memorial Hospital Decatur, Illinois >>> jeff nolder 01/21/08 3:20 PM >>> Hello group, we are a small town hospital with three chiropractic clinics in town. We have recently seen an increase in referrals from chiropractic offices. In the past we have not allowed these and need a referral from a family doc to treat. We have found that most of these patients will not go to the family doc and are just staying with the chiropractors. We would like to be able to see these patients and do not want to exclude a referral source. Our policy at the hosiptal is that every pateint needs to have a doctors referral to be seen. I would like to see these patients but unsure how to go about doing this? Secondary to liability issues and payment issues for multiple insurances, do anyone have a good solutions or ideas how to fix this problem? thanks for the help Jeff Nolder, PT Director of Physical Medicine and Rehab Cherokee Regional Medical Center _________________________________________________________________ Climb to the top of the charts! Play the word scramble challenge with star power. http://club.live.com/star_shuffle.aspx?icid=starshuffle_wlmailtextlink_jan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 21, 2008 Report Share Posted January 21, 2008 What state are you in? Are you direct access for both eval and treat or eval only? If neither, are chiros listed in your state practice act as a referral source as are MD's, DO's, PA's NP's? We can discuss treatment approaches and patient handling techniques. I am in a small town also and these situations need to be handled careful, you know, small town politics... Also, this is part of the push of chiros to begin or exert " superiority in skills, see I refer to you, therefore we are not equals. " Good article to read regarding this topic. " Can Chiros and Evidence Based Manual Therapists work together? An opinion from a veteran Chiro. " Journal of Manual and Manipulative Therapy, 2006, Vol. 14, No. 2, E14-18. Roll PT, OCS, FAAOMPT www.ptcos.com Ocean Springs, MS > > > Hello group, we are a small town hospital with three chiropractic clinics in town. We have recently seen an increase in referrals from chiropractic offices. In the past we have not allowed these and need a referral from a family doc to treat. We have found that most of these patients will not go to the family doc and are just staying with the chiropractors. We would like to be able to see these patients and do not want to exclude a referral source. Our policy at the hosiptal is that every pateint needs to have a doctors referral to be seen. I would like to see these patients but unsure how to go about doing this? Secondary to liability issues and payment issues for multiple insurances, do anyone have a good solutions or ideas how to fix this problem? thanks for the help > > Jeff Nolder, PT > Director of Physical Medicine and Rehab > Cherokee Regional Medical Center > > _________________________________________________________________ > Climb to the top of the charts! Play the word scramble challenge with star power. > http://club.live.com/star_shuffle.aspx? icid=starshuffle_wlmailtextlink_jan > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 21, 2008 Report Share Posted January 21, 2008 We have accepted these referrals in the past, but had a confirmation order and plan of care signed by their primary physician or the chief of staff. We do not release the evaluation or medical notes to the chiropractor. We also educate the patient on insurance benefits so that the insurance is not billed for two similar treatments in the same day with one large denial. le Bohl, PT Rehab Manager County Health Systems This email and any files transmitted with it are confidential and are intended solely for the use of the individual or entity to which they are addressed. This communication may contain materials protected by copyright, or confidentiality and non-disclosure agreements. Be advised that the unauthorized dissemination, forwarding, printing, or copying of this email is strictly prohibited. If you are not the intended recipient of this email, please notify me immediately at dbohl@.... chiropractors Hello group, we are a small town hospital with three chiropractic clinics in town. We have recently seen an increase in referrals from chiropractic offices. In the past we have not allowed these and need a referral from a family doc to treat. We have found that most of these patients will not go to the family doc and are just staying with the chiropractors. We would like to be able to see these patients and do not want to exclude a referral source. Our policy at the hosiptal is that every pateint needs to have a doctors referral to be seen. I would like to see these patients but unsure how to go about doing this? Secondary to liability issues and payment issues for multiple insurances, do anyone have a good solutions or ideas how to fix this problem? thanks for the help Jeff Nolder, PT Director of Physical Medicine and Rehab Cherokee Regional Medical Center __________________________________________________________ Climb to the top of the charts! Play the word scramble challenge with star power. http://club.live.com/star_shuffle.aspx?icid=starshuffle_wlmailtextlink_jan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 21, 2008 Report Share Posted January 21, 2008 Jeff, I read your posting with great empathy. When I first started in my position at our hospital the same policy was in place. We needed a script for all patients (including out-patients). I met with our medical records manager and director of patient services as well as our CEO on 2 or 3 occasions and was successful in having the policy changed. The main questions these individuals needed answered were: 1. What does the state practice act say about direct access? 2. What does CMS (Medicare) say about no referral? (Chiropractors are not allowed by CMS as a referral source which is a problem in itself). 3. How will our liability/malpractice insurance be affected by having no referrals? 4. Is it in the scope of practice for therapists to administer care without the supervision of an MD? I did my homework and had answers for all questions. At the time we changed the policy CMS still required a referral so, we got referrals for CMS patients. Our other insurers for the most part did/do not require referrals. We did also make a point to educate the local physicians so as to not alienate them after years of making the referrals. Out of 20 or so providers only one had a problem with losing this " control " but, they did get over it. Now that CMS requires no referral we don't typically get scripts even for these patients. Some doctors still send them and occasionally we'll get a strange third party payer that still requires a script. As for the CMS patients who are being referred by chiropractors we have had that come up as well. Our typical action is to educate the patient as to what CMS requires and that we are required by them to send their POC to an MD, nurse practitioner, etc (see the CMS regs) and to then find out who they would like us to have their POC approved by. If the patient refuses to see an eligible provider then the entire financial responsibility then falls on them. Hope this helps. It is likely a matter of education for the other department heads and directors/v.p.s in your organization to get this accomplished. Hope this helps. Chad Chad W. Yoakam, MS, PT Manager of Rehabilitation Services Livingston HealthCare Orthopedic and Rehabilitation Institute ________________________________ From: PTManager [mailto:PTManager ] On Behalf Of jeff nolder Sent: Monday, January 21, 2008 2:20 PM To: ptmanager Subject: chiropractors Hello group, we are a small town hospital with three chiropractic clinics in town. We have recently seen an increase in referrals from chiropractic offices. In the past we have not allowed these and need a referral from a family doc to treat. We have found that most of these patients will not go to the family doc and are just staying with the chiropractors. We would like to be able to see these patients and do not want to exclude a referral source. Our policy at the hosiptal is that every pateint needs to have a doctors referral to be seen. I would like to see these patients but unsure how to go about doing this? Secondary to liability issues and payment issues for multiple insurances, do anyone have a good solutions or ideas how to fix this problem? thanks for the help Jeff Nolder, PT Director of Physical Medicine and Rehab Cherokee Regional Medical Center __________________________________________________________ Climb to the top of the charts! Play the word scramble challenge with star power. http://club.live.com/star_shuffle.aspx?icid=starshuffle_wlmailtextlink_j an <http://club.live.com/star_shuffle.aspx?icid=starshuffle_wlmailtextlink_ jan> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 21, 2008 Report Share Posted January 21, 2008 What does your state practice act say about referrals from chiropractors?? I think I would start with that bit on information and build your policy from there.? Drilling,PT Director of Rehabilitation Sservice Henrico Health Care chiropractors Hello group, we are a small town hospital with three chiropractic clinics in town. We have recently seen an increase in referrals from chiropractic offices. In the past we have not allowed these and need a referral from a family doc to treat. We have found that most of these patients will not go to the family doc and are just staying with the chiropractors. We would like to be able to see these patients and do not want to exclude a referral source. Our policy at the hosiptal is that every pateint needs to have a doctors referral to be seen. I would like to see these patients but unsure how to go about doing this? Secondary to liability issues and payment issues for multiple insurances, do anyone have a good solutions or ideas how to fix this problem? thanks for the help Jeff Nolder, PT Director of Physical Medicine and Rehab Cherokee Regional Medical Center __________________________________________________________ Climb to the top of the charts!?Play the word scramble challenge with star power. http://club.live.com/star_shuffle.aspx?icid=starshuffle_wlmailtextlink_jan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 22, 2008 Report Share Posted January 22, 2008 The definition of a " physician " in Illinois includes chiropractors and podiatrists. Mollie Beyers, PT, DPT Pana Community Hospital Re: chiropractors Hi Jeff, I would suggest checking with your state statutes. In Florida we are allowed to accept a referral from a chiropractor. Hope this helps. Jill Piazza, PT, MSPT Florida Hospital Deland ---- jeff nolder wrote: ============= Hello group, we are a small town hospital with three chiropractic clinics in town. We have recently seen an increase in referrals from chiropractic offices. In the past we have not allowed these and need a referral from a family doc to treat. We have found that most of these patients will not go to the family doc and are just staying with the chiropractors. We would like to be able to see these patients and do not want to exclude a referral source. Our policy at the hosiptal is that every pateint needs to have a doctors referral to be seen. I would like to see these patients but unsure how to go about doing this? Secondary to liability issues and payment issues for multiple insurances, do anyone have a good solutions or ideas how to fix this problem? thanks for the help Jeff Nolder, PT Director of Physical Medicine and Rehab Cherokee Regional Medical Center __________________________________________________________ Climb to the top of the charts! Play the word scramble challenge with star power. http://club.live.com/star_shuffle.aspx?icid=starshuffle_wlmailtextlink_jan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 22, 2008 Report Share Posted January 22, 2008 Okay Jeff.. This morning, I received a call from Vicky ( past president of IPTA (?) - thank you for your call! ) and verified that definition of physician under IL includes Chiropractors. So, I checked out the wonderful WWW and this is what I found. According to Medical Practice Act of 1987, the definition of physician is as follows: 10. " Physician " means a person licensed under the Medical Practice Act to practice medicine in all of its branches or a chiropractic physician licensed to treat human ailments without the use of drugs and without operative surgery. Retrieved January 22, 2008 from http://law.justia.com/illinois/codes/chapter24/1309.html I agree with you Jeff, but I guess it is plainly written in our IL law. But I guess we still could not accept Chiro referrals for Medicare patients(?) Thanks and hope this clarify things. J Rhoda Astronomo, PT President R.A. Physical Therapy Gibson City, IL 60936 From: PTManager [mailto:PTManager ] On Behalf Of BROWN,JEFF Sent: Tuesday, January 22, 2008 8:03 AM To: PTManager Subject: RE: chiropractors Rhonda, You will need to contact them. I also interpreted the Practice Act as you did and I ran into an " issue " with a local Chiropractor who referred to us. It was further complicated by our then Rehab. med director (who was in name only, he had absolutely no interchange with us) stated we absolutely could not see off chiropractic referral. This is when I went to the IPTA and it was their position that chiropractor was covered by the word " physician " in the statement you quoted from the Practice Act. I urge you to contact the IPTA as well and let me know if this is changed or just plain wrong. ly, I would not like to have our referral sources open to chiropractors. As I mentioned in my previous message it is my opinion that this has been more trouble than it is worth. We have been educating MD's, nurses, etc... for years as to what we can do, when, how much and have with great effort finally gotten the trust and respect we deserve. This has been gained with positive outcomes based on our (Physical Therapist) knowledge and skill, as well as constant communication with the rest of the medical community as to what we do. With my chiropractic referrals the POC has often been changed, negated, and on occation belittled. I know I am preaching to the chior and this is not anything you don't know or haven't been through yourself. This issue has always been a burr in my saddle. Again I urge you to contact the IPTA and let me know if I was in the wrong. Jeff Brown PT Director of Rehabilitation Decatur Memorial Hospital Decatur, Illinois >>> " Rhoda Astronomo " <rhodapt@... <mailto:rhodapt%40sbcglobal.net> > 01/21/08 5:41 PM >>> Jeff, I am also in Illinois.. and as I read the IL Practice act regarding referral.. it states: (6) " Referral " means a written or oral authorization for physical therapy services for a patient by a physician, dentist, advanced practice nurse, physician assistant, or podiatrist who maintains medical supervision of the patient and makes a diagnosis or verifies that the patient's condition is such that it may be treated by a physical therapist. Here is the link: Illinois Physical Therapy Practice Act. Illinois General Assembly. Retrieved 1/21/08 from http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 & ChapAct=225%26nbsp%3B > & ChapAct=225%26nbsp%3B ILCS%26nbsp%3B90%2F & Chap> & ChapAct=225%26nbsp%3BILCS%26nbsp%3B90%2F & Chap I do not see Chiropractors anywhere in our practice act. Could you please let me know where you find your statement " The Illinios Physical Therapy Assoc. states that our Practice Act allows for PT's to eval/treat from Chiropractic referrals " ? Thanks. Rhoda Astronomo, PT President R.A. Physical Therapy, PC Gibson City, IL From: PTManager <mailto:PTManager%40yahoogroups.com> [mailto:PTManager <mailto:PTManager%40yahoogroups.com> ] On Behalf Of BROWN,JEFF Sent: Monday, January 21, 2008 4:20 PM To: ptmanager <mailto:ptmanager%40yahoogroups.com> Subject: Re: chiropractors Jeff, The Illinios Physical Therapy Assoc. states that our Practice Act allows for PT's to eval/treat from Chiropractic referrals. This has been all that we have needed to see these patients in our hospital system. As far as the reimbursement issue there have been so few that I have not gotten word from our business office as to not having coverage. The one thing I have been most concerned about is the dual treatment of our service and the chiropractors treatment. My personal experience is that this has not been very successful. I have found more often than not that my plan of care has been altered, added too, or negated. Take this for what it is worth. Jeff Brown PT Director of Rehabilitation Decatur Memorial Hospital Decatur, Illinois >>> jeff nolder <nolderj@... <mailto:nolderj%40hotmail.com> <mailto:nolderj%40hotmail.com> > 01/21/08 3:20 PM >>> Hello group, we are a small town hospital with three chiropractic clinics in town. We have recently seen an increase in referrals from chiropractic offices. In the past we have not allowed these and need a referral from a family doc to treat. We have found that most of these patients will not go to the family doc and are just staying with the chiropractors. We would like to be able to see these patients and do not want to exclude a referral source. Our policy at the hosiptal is that every pateint needs to have a doctors referral to be seen. I would like to see these patients but unsure how to go about doing this? Secondary to liability issues and payment issues for multiple insurances, do anyone have a good solutions or ideas how to fix this problem? thanks for the help Jeff Nolder, PT Director of Physical Medicine and Rehab Cherokee Regional Medical Center __________________________________________________________ Climb to the top of the charts! Play the word scramble challenge with star power. http://club.live.com/star_shuffle.aspx?icid=starshuffle_wlmailtextlink_jan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 24, 2008 Report Share Posted January 24, 2008 Group, I have found the same to be true with the interpretation of the Illinois Practice Act. However, I think we also need to bear in mind that Rev. 63 issued on 12-29-06 regarding coverage of outpatient therapy services states " Chiropractors and doctors of dental surgery or dental medicine are not considered physicians for therapy services and may neither refer patients for rehabilitation therapy services nor establish therapy plans of care " . These discrepancies between federal and state regs do create some confusion for our staff and our patients. I emphathize with all of you. Beth Hall, MPT The Wellness Complex Manager 825 New York Drive,Suite 2 Vandalia, IL 62471 Phone (618)283-5549 FAX (618)283-2951 beth.hall@... [beth Hall] Re: chiropractors Jeff, The Illinios Physical Therapy Assoc. states that our Practice Act allows for PT's to eval/treat from Chiropractic referrals. This has been all that we have needed to see these patients in our hospital system. As far as the reimbursement issue there have been so few that I have not gotten word from our business office as to not having coverage. The one thing I have been most concerned about is the dual treatment of our service and the chiropractors treatment. My personal experience is that this has not been very successful. I have found more often than not that my plan of care has been altered, added too, or negated. Take this for what it is worth. Jeff Brown PT Director of Rehabilitation Decatur Memorial Hospital Decatur, Illinois >>> jeff nolder < nolderjhotmail (DOT) <mailto:nolderj%40hotmail.com> com <mailto:nolderj%40hotmail.com> > 01/21/08 3:20 PM >>> Hello group, we are a small town hospital with three chiropractic clinics in town. We have recently seen an increase in referrals from chiropractic offices. In the past we have not allowed these and need a referral from a family doc to treat. We have found that most of these patients will not go to the family doc and are just staying with the chiropractors. We would like to be able to see these patients and do not want to exclude a referral source. Our policy at the hosiptal is that every pateint needs to have a doctors referral to be seen. I would like to see these patients but unsure how to go about doing this? Secondary to liability issues and payment issues for multiple insurances, do anyone have a good solutions or ideas how to fix this problem? thanks for the help Jeff Nolder, PT Director of Physical Medicine and Rehab Cherokee Regional Medical Center __________________________________________________________ Climb to the top of the charts! Play the word scramble challenge with star power. http://club. <http://club.live.com/star_shuffle.aspx?icid=starshuffle_wlmailtextlink_jan> live.com/star_shuffle.aspx?icid=starshuffle_wlmailtextlink_jan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 4, 2008 Report Share Posted February 4, 2008 I completely agree. I posted a similar opinion a few weeks ago. I often see chiropractors refer to us assuming we are to perform the exercise portion of rehab while they do the manual work. I always advise my patients to not do both chiropractic and physical therapy simultaneously. Bisesi MPT COMT Winter Haven, Fl --- Stanley Paris wrote: > Here's my take. If you are going to treat a patient > referred from a > chiropractor make sure its a referral and that you > are responsible for > the evaluation and the treatment that follows and > that during this > period the chiropractor is not engaged in treating > the patient. Do not > accept a prescription for modalities especially > while the chiropractor > continues with his/her administrations. > Stanley Paris > > ________________________________ > > From: PTManager > [mailto:PTManager ] On > Behalf Of Mourning, Todd > Sent: Tuesday, January 22, 2008 9:48 AM > To: 'PTManager ' > Subject: RE: chiropractors > > > > We have been under the impression that since Chiro's > are listed as Chiro > Physician, we do have the ability to see them. > Doesn't happen very much > in Lincoln but if it does, we usually do see them. > We will generally > recommend that the pt go see their primary and > confirm the dx and get a > referral from them. > > Todd Mourning, PT > > Abraham Lincoln Memorial Hospital > Lincoln, IL > > ________________________________ > From: PTManager > <mailto:PTManager%40yahoogroups.com> > [mailto:PTManager > <mailto:PTManager%40yahoogroups.com> ] > On Behalf Of Rhoda Astronomo > Sent: Monday, January 21, 2008 5:42 PM > To: PTManager > <mailto:PTManager%40yahoogroups.com> > Subject: RE: chiropractors > > Jeff, > > I am also in Illinois.. and as I read the IL > Practice act regarding > referral.. it states: > > (6) " Referral " means a written or oral authorization > for physical > therapy > services for a patient by a physician, dentist, > advanced practice nurse, > physician assistant, or podiatrist who maintains > medical supervision of > the > patient and makes a diagnosis or verifies that the > patient's condition > is > such that it may be treated by a physical therapist. > > Here is the link: > > Illinois Physical Therapy Practice Act. Illinois > General Assembly. > Retrieved 1/21/08 from > http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 > <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319> > > <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 & ChapAct=225%26nbs > p%3B > <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 & ChapAct=225%26nbs > p%3B> > ILCS%26nbsp%3B90%2F & Chap> > & ChapAct=225%26nbsp%3BILCS%26nbsp%3B90%2F & Chap > > I do not see Chiropractors anywhere in our practice > act. Could you > please > let me know where you find your statement " The > Illinios Physical Therapy > Assoc. states that our Practice Act allows for PT's > to eval/treat from > Chiropractic referrals " ? > > Thanks. > > Rhoda Astronomo, PT > > President > > R.A. Physical Therapy, PC > > Gibson City, IL > > > > From: PTManager > <mailto:PTManager%40yahoogroups.com> > <mailto:PTManager%40yahoogroups.com> > [mailto:PTManager > <mailto:PTManager%40yahoogroups.com> > <mailto:PTManager%40yahoogroups.com>] On Behalf > Of BROWN,JEFF > Sent: Monday, January 21, 2008 4:20 PM > To: ptmanager > <mailto:ptmanager%40yahoogroups.com> > <mailto:ptmanager%40yahoogroups.com> > Subject: Re: chiropractors > > Jeff, > The Illinios Physical Therapy Assoc. states that our > Practice Act allows > for > PT's to eval/treat from Chiropractic referrals. This > has been all that > we > have needed to see these patients in our hospital > system. As far as the > reimbursement issue there have been so few that I > have not gotten word > from > our business office as to not having coverage. > > The one thing I have been most concerned about is > the dual treatment of > our > service and the chiropractors treatment. My personal > experience is that > this > has not been very successful. I have found more > often than not that my > plan > of care has been altered, added too, or negated. > > Take this for what it is worth. > > Jeff Brown PT > Director of Rehabilitation > Decatur Memorial Hospital > Decatur, Illinois > > >>> jeff nolder <nolderj@... > <mailto:nolderj%40hotmail.com> > <mailto:nolderj%40hotmail.com> > <mailto:nolderj%40hotmail.com> > > 01/21/08 3:20 PM >>> > > Hello group, we are a small town hospital with three > chiropractic > clinics in > town. We have recently seen an increase in referrals > from chiropractic > offices. In the past we have not allowed these and > need a referral from > a > family doc to treat. We have found that most of > these patients will not > go > to the family doc and are just staying with the > chiropractors. We would > like > to be able to see these patients and do not want to > exclude a referral > source. Our policy at the hosiptal is that every > pateint needs to have a > doctors referral to be seen. I would like to see > these patients but > unsure > how to go about doing this? Secondary to liability > issues and payment > issues > for multiple insurances, do anyone have a good > solutions or ideas how to > fix > this problem? thanks for the help > > Jeff Nolder, PT > Director of Physical Medicine and Rehab > Cherokee Regional Medical Center > > __________________________________________________________ > Climb to the top of the charts! Play the word > scramble challenge with > star > power. > http://club.live.com/star_shuffle.aspx?icid=starshuffle_wlmailtextlink_j > an > <http://club.live.com/star_shuffle.aspx?icid=starshuffle_wlmailtextlink_ > jan> > > [Non-text portions of this message have been > removed] > === message truncated === ________________________________________________________________________________\ ____ Never miss a thing. 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Guest guest Posted February 5, 2008 Report Share Posted February 5, 2008 Ditto, I tell mypatients to either do PT or Chiro but not both at the same time. And so far with exception of one patient, everyone chooses to do PT. Hiten Dave' PT Re: chiropractors > > Jeff, > The Illinios Physical Therapy Assoc. states that our > Practice Act allows > for > PT's to eval/treat from Chiropractic referrals. This > has been all that > we > have needed to see these patients in our hospital > system. As far as the > reimbursement issue there have been so few that I > have not gotten word > from > our business office as to not having coverage. > > The one thing I have been most concerned about is > the dual treatment of > our > service and the chiropractors treatment. My personal > experience is that > this > has not been very successful. I have found more > often than not that my > plan > of care has been altered, added too, or negated. > > Take this for what it is worth. > > Jeff Brown PT > Director of Rehabilitation > Decatur Memorial Hospital > Decatur, Illinois > > >>> jeff nolder <HYPERLINK " mailto:nolderj%40hotmail.com " nolderjhotmail (DOT) -com > <mailto:nolderj%-40hotmail.-com> > <mailto:nolderj%-40hotmail.-com> > <mailto:nolderj%-40hotmail.-com> > > 01/21/08 3:20 PM >>> > > Hello group, we are a small town hospital with three > chiropractic > clinics in > town. We have recently seen an increase in referrals > from chiropractic > offices. In the past we have not allowed these and > need a referral from > a > family doc to treat. We have found that most of > these patients will not > go > to the family doc and are just staying with the > chiropractors. We would > like > to be able to see these patients and do not want to > exclude a referral > source. Our policy at the hosiptal is that every > pateint needs to have a > doctors referral to be seen. I would like to see > these patients but > unsure > how to go about doing this? Secondary to liability > issues and payment > issues > for multiple insurances, do anyone have a good > solutions or ideas how to > fix > this problem? thanks for the help > > Jeff Nolder, PT > Director of Physical Medicine and Rehab > Cherokee Regional Medical Center > > ____________-_________-_________-_________-_________-_________-_ > Climb to the top of the charts! Play the word > scramble challenge with > star > power. > HYPERLINK " http://club.live.com/star_shuffle.aspx?icid=starshuffle_wlmailtextlink_j " ht tp://club.-live.com/-star_shuffle.-aspx?icid=-starshuffle_-wlmailtextlink_-j > an > <HYPERLINK " http://club.live.com/star_shuffle.aspx?icid=starshuffle_wlmailtextlink_ " htt p://club.-live.com/-star_shuffle.-aspx?icid=-starshuffle_-wlmailtextlink_ > jan> > > [Non-text portions of this message have been > removed] > === message truncated === ____________-_________-_________-_________-_________-_________-_ Never miss a thing. Make Yahoo your home page. HYPERLINK " http://www.yahoo.com/r/hs " http://www.yahoo.-com/r/hs No virus found in this incoming message. Checked by AVG Free Edition. Version: 7.5.516 / Virus Database: 269.19.19/1256 - Release Date: 2/2/2008 1:50 PM No virus found in this outgoing message. Checked by AVG Free Edition. Version: 7.5.516 / Virus Database: 269.19.19/1256 - Release Date: 2/2/2008 1:50 PM Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 5, 2008 Report Share Posted February 5, 2008 There is no evidence that I know of in the literature that co-treating a patient with another manual-based clinican such as a chiropractor is detrimental to the patient. Schweitzer " Dogma is the curse of learning. " - Laurie Hartman keith bisesi wrote: I completely agree. I posted a similar opinion a few weeks ago. I often see chiropractors refer to us assuming we are to perform the exercise portion of rehab while they do the manual work. I always advise my patients to not do both chiropractic and physical therapy simultaneously. Bisesi MPT COMT Winter Haven, Fl --- Stanley Paris wrote: > Here's my take. If you are going to treat a patient > referred from a > chiropractor make sure its a referral and that you > are responsible for > the evaluation and the treatment that follows and > that during this > period the chiropractor is not engaged in treating > the patient. Do not > accept a prescription for modalities especially > while the chiropractor > continues with his/her administrations. > Stanley Paris > > ________________________________ > > From: PTManager > [mailto:PTManager ] On > Behalf Of Mourning, Todd > Sent: Tuesday, January 22, 2008 9:48 AM > To: 'PTManager ' > Subject: RE: chiropractors > > > > We have been under the impression that since Chiro's > are listed as Chiro > Physician, we do have the ability to see them. > Doesn't happen very much > in Lincoln but if it does, we usually do see them. > We will generally > recommend that the pt go see their primary and > confirm the dx and get a > referral from them. > > Todd Mourning, PT > > Abraham Lincoln Memorial Hospital > Lincoln, IL > > ________________________________ > From: PTManager > <mailto:PTManager%40yahoogroups.com> > [mailto:PTManager > <mailto:PTManager%40yahoogroups.com> ] > On Behalf Of Rhoda Astronomo > Sent: Monday, January 21, 2008 5:42 PM > To: PTManager > <mailto:PTManager%40yahoogroups.com> > Subject: RE: chiropractors > > Jeff, > > I am also in Illinois.. and as I read the IL > Practice act regarding > referral.. it states: > > (6) " Referral " means a written or oral authorization > for physical > therapy > services for a patient by a physician, dentist, > advanced practice nurse, > physician assistant, or podiatrist who maintains > medical supervision of > the > patient and makes a diagnosis or verifies that the > patient's condition > is > such that it may be treated by a physical therapist. > > Here is the link: > > Illinois Physical Therapy Practice Act. Illinois > General Assembly. > Retrieved 1/21/08 from > http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 > <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319> > > <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 & ChapAct=225%26nbs > p%3B > <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 & ChapAct=225%26nbs > p%3B> > ILCS%26nbsp%3B90%2F & Chap> > & ChapAct=225%26nbsp%3BILCS%26nbsp%3B90%2F & Chap > > I do not see Chiropractors anywhere in our practice > act. Could you > please > let me know where you find your statement " The > Illinios Physical Therapy > Assoc. states that our Practice Act allows for PT's > to eval/treat from > Chiropractic referrals " ? > > Thanks. > > Rhoda Astronomo, PT > > President > > R.A. Physical Therapy, PC > > Gibson City, IL > > > > From: PTManager > <mailto:PTManager%40yahoogroups.com> > <mailto:PTManager%40yahoogroups.com> > [mailto:PTManager > <mailto:PTManager%40yahoogroups.com> > <mailto:PTManager%40yahoogroups.com>] On Behalf > Of BROWN,JEFF > Sent: Monday, January 21, 2008 4:20 PM > To: ptmanager > <mailto:ptmanager%40yahoogroups.com> > <mailto:ptmanager%40yahoogroups.com> > Subject: Re: chiropractors > > Jeff, > The Illinios Physical Therapy Assoc. states that our > Practice Act allows > for > PT's to eval/treat from Chiropractic referrals. This > has been all that > we > have needed to see these patients in our hospital > system. As far as the > reimbursement issue there have been so few that I > have not gotten word > from > our business office as to not having coverage. > > The one thing I have been most concerned about is > the dual treatment of > our > service and the chiropractors treatment. My personal > experience is that > this > has not been very successful. I have found more > often than not that my > plan > of care has been altered, added too, or negated. > > Take this for what it is worth. > > Jeff Brown PT > Director of Rehabilitation > Decatur Memorial Hospital > Decatur, Illinois > > >>> jeff nolder <nolderj@... > <mailto:nolderj%40hotmail.com> > <mailto:nolderj%40hotmail.com> > <mailto:nolderj%40hotmail.com> > > 01/21/08 3:20 PM >>> > > Hello group, we are a small town hospital with three > chiropractic > clinics in > town. We have recently seen an increase in referrals > from chiropractic > offices. In the past we have not allowed these and > need a referral from > a > family doc to treat. We have found that most of > these patients will not > go > to the family doc and are just staying with the > chiropractors. We would > like > to be able to see these patients and do not want to > exclude a referral > source. Our policy at the hosiptal is that every > pateint needs to have a > doctors referral to be seen. I would like to see > these patients but > unsure > how to go about doing this? Secondary to liability > issues and payment > issues > for multiple insurances, do anyone have a good > solutions or ideas how to > fix > this problem? thanks for the help > > Jeff Nolder, PT > Director of Physical Medicine and Rehab > Cherokee Regional Medical Center > > __________________________________________________________ > Climb to the top of the charts! Play the word > scramble challenge with > star > power. > http://club.live.com/star_shuffle.aspx?icid=starshuffle_wlmailtextlink_j > an > <http://club.live.com/star_shuffle.aspx?icid=starshuffle_wlmailtextlink_ > jan> > > [Non-text portions of this message have been > removed] > === message truncated === __________________________________________________________ Never miss a thing. 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Guest guest Posted February 5, 2008 Report Share Posted February 5, 2008 CVA, instability, etc ... Who's to say what or who potentially precipitated an event? I would use some logic here but bottom line is you've got to be comfortable with this. Does a patient need to see both? If I'm not helping with manual or educational skills, and the patient felt they got more with chiropractic care, then I advise them to go were they " were better " . I just encourage them to seek an active vs. passive means of self-management for the long term. No questions with this approach. Jim Storch, PT, Cert. MDT ________________________________ From: PTManager [mailto:PTManager ] On Behalf Of Schweitzer Sent: Tuesday, February 05, 2008 12:39 PM To: PTManager Subject: RE: chiropractors There is no evidence that I know of in the literature that co-treating a patient with another manual-based clinican such as a chiropractor is detrimental to the patient. Schweitzer " Dogma is the curse of learning. " - Laurie Hartman keith bisesi <kbisesi@... <mailto:kbisesi%40yahoo.com> > wrote: I completely agree. I posted a similar opinion a few weeks ago. I often see chiropractors refer to us assuming we are to perform the exercise portion of rehab while they do the manual work. I always advise my patients to not do both chiropractic and physical therapy simultaneously. Bisesi MPT COMT Winter Haven, Fl --- Stanley Paris <sparis@... <mailto:sparis%40usa.edu> > wrote: > Here's my take. If you are going to treat a patient > referred from a > chiropractor make sure its a referral and that you > are responsible for > the evaluation and the treatment that follows and > that during this > period the chiropractor is not engaged in treating > the patient. Do not > accept a prescription for modalities especially > while the chiropractor > continues with his/her administrations. > Stanley Paris > > ________________________________ > > From: PTManager <mailto:PTManager%40yahoogroups.com> > [mailto:PTManager <mailto:PTManager%40yahoogroups.com> ] On > Behalf Of Mourning, Todd > Sent: Tuesday, January 22, 2008 9:48 AM > To: 'PTManager <mailto:%27PTManager%40yahoogroups.com> ' > Subject: RE: chiropractors > > > > We have been under the impression that since Chiro's > are listed as Chiro > Physician, we do have the ability to see them. > Doesn't happen very much > in Lincoln but if it does, we usually do see them. > We will generally > recommend that the pt go see their primary and > confirm the dx and get a > referral from them. > > Todd Mourning, PT > > Abraham Lincoln Memorial Hospital > Lincoln, IL > > ________________________________ > From: PTManager <mailto:PTManager%40yahoogroups.com> > <mailto:PTManager%40yahoogroups.com> > [mailto:PTManager <mailto:PTManager%40yahoogroups.com> > <mailto:PTManager%40yahoogroups.com> ] > On Behalf Of Rhoda Astronomo > Sent: Monday, January 21, 2008 5:42 PM > To: PTManager <mailto:PTManager%40yahoogroups.com> > <mailto:PTManager%40yahoogroups.com> > Subject: RE: chiropractors > > Jeff, > > I am also in Illinois.. and as I read the IL > Practice act regarding > referral.. it states: > > (6) " Referral " means a written or oral authorization > for physical > therapy > services for a patient by a physician, dentist, > advanced practice nurse, > physician assistant, or podiatrist who maintains > medical supervision of > the > patient and makes a diagnosis or verifies that the > patient's condition > is > such that it may be treated by a physical therapist. > > Here is the link: > > Illinois Physical Therapy Practice Act. Illinois > General Assembly. > Retrieved 1/21/08 from > http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319> > <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319> > > > <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 & ChapAct=225%26nbs <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 & ChapAct=225%26nbs > > p%3B > <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 & ChapAct=225%26nbs <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 & ChapAct=225%26nbs > > p%3B> > ILCS%26nbsp%3B90%2F & Chap> > & ChapAct=225%26nbsp%3BILCS%26nbsp%3B90%2F & Chap > > I do not see Chiropractors anywhere in our practice > act. Could you > please > let me know where you find your statement " The > Illinios Physical Therapy > Assoc. states that our Practice Act allows for PT's > to eval/treat from > Chiropractic referrals " ? > > Thanks. > > Rhoda Astronomo, PT > > President > > R.A. Physical Therapy, PC > > Gibson City, IL > > > > From: PTManager <mailto:PTManager%40yahoogroups.com> > <mailto:PTManager%40yahoogroups.com> > <mailto:PTManager%40yahoogroups.com> > [mailto:PTManager <mailto:PTManager%40yahoogroups.com> > <mailto:PTManager%40yahoogroups.com> > <mailto:PTManager%40yahoogroups.com>] On Behalf > Of BROWN,JEFF > Sent: Monday, January 21, 2008 4:20 PM > To: ptmanager <mailto:ptmanager%40yahoogroups.com> > <mailto:ptmanager%40yahoogroups.com> > <mailto:ptmanager%40yahoogroups.com> > Subject: Re: chiropractors > > Jeff, > The Illinios Physical Therapy Assoc. states that our > Practice Act allows > for > PT's to eval/treat from Chiropractic referrals. This > has been all that > we > have needed to see these patients in our hospital > system. As far as the > reimbursement issue there have been so few that I > have not gotten word > from > our business office as to not having coverage. > > The one thing I have been most concerned about is > the dual treatment of > our > service and the chiropractors treatment. My personal > experience is that > this > has not been very successful. I have found more > often than not that my > plan > of care has been altered, added too, or negated. > > Take this for what it is worth. > > Jeff Brown PT > Director of Rehabilitation > Decatur Memorial Hospital > Decatur, Illinois > > >>> jeff nolder <nolderj@... <mailto:nolderj%40hotmail.com> > <mailto:nolderj%40hotmail.com> > <mailto:nolderj%40hotmail.com> > <mailto:nolderj%40hotmail.com> > > 01/21/08 3:20 PM >>> > > Hello group, we are a small town hospital with three > chiropractic > clinics in > town. We have recently seen an increase in referrals > from chiropractic > offices. In the past we have not allowed these and > need a referral from > a > family doc to treat. We have found that most of > these patients will not > go > to the family doc and are just staying with the > chiropractors. We would > like > to be able to see these patients and do not want to > exclude a referral > source. Our policy at the hosiptal is that every > pateint needs to have a > doctors referral to be seen. I would like to see > these patients but > unsure > how to go about doing this? Secondary to liability > issues and payment > issues > for multiple insurances, do anyone have a good > solutions or ideas how to > fix > this problem? thanks for the help > > Jeff Nolder, PT > Director of Physical Medicine and Rehab > Cherokee Regional Medical Center > > __________________________________________________________ > Climb to the top of the charts! Play the word > scramble challenge with > star > power. > http://club.live.com/star_shuffle.aspx?icid=starshuffle_wlmailtextlink_j <http://club.live.com/star_shuffle.aspx?icid=starshuffle_wlmailtextlink_ j> > an > <http://club.live.com/star_shuffle.aspx?icid=starshuffle_wlmailtextlink_ <http://club.live.com/star_shuffle.aspx?icid=starshuffle_wlmailtextlink_ > > jan> > > [Non-text portions of this message have been > removed] > === message truncated === __________________________________________________________ Never miss a thing. Make Yahoo your home page. http://www.yahoo.com/r/hs <http://www.yahoo.com/r/hs> --------------------------------- Never miss a thing. Make Yahoo your homepage. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 5, 2008 Report Share Posted February 5, 2008 It's not really an evidence based practice or research based comment. It's simply not necessary. If you're seeking two similar treatment options, how do you know which is helping? I wouldn't have two mechanics co-repair my car's engine. It would be similar to an MD referring a patient to an OT and to a PT for a wrist injury - I would advise a patient to see one or the other. Regarding the chiropractic referral example, I would have the patient begin PT when the chiropractic care was complete. I wouldn't try to take the patient away from the chiro who referred him/her. Bisesi MPT COMT Winter Haven, Fl --- Schweitzer wrote: > There is no evidence that I know of in the > literature that co-treating a patient with another > manual-based clinican such as a chiropractor is > detrimental to the patient. > > Schweitzer > > " Dogma is the curse of learning. " - Laurie Hartman > > > > keith bisesi wrote: > I completely agree. I posted a similar > opinion a few > weeks ago. I often see chiropractors refer to us > assuming we are to perform the exercise portion of > rehab while they do the manual work. I always advise > my patients to not do both chiropractic and physical > therapy simultaneously. > > Bisesi MPT COMT > Winter Haven, Fl > > --- Stanley Paris wrote: > > > Here's my take. If you are going to treat a > patient > > referred from a > > chiropractor make sure its a referral and that you > > are responsible for > > the evaluation and the treatment that follows and > > that during this > > period the chiropractor is not engaged in treating > > the patient. Do not > > accept a prescription for modalities especially > > while the chiropractor > > continues with his/her administrations. > > Stanley Paris > > > > ________________________________ > > > > From: PTManager > > [mailto:PTManager ] On > > Behalf Of Mourning, Todd > > Sent: Tuesday, January 22, 2008 9:48 AM > > To: 'PTManager ' > > Subject: RE: chiropractors > > > > > > > > We have been under the impression that since > Chiro's > > are listed as Chiro > > Physician, we do have the ability to see them. > > Doesn't happen very much > > in Lincoln but if it does, we usually do see them. > > We will generally > > recommend that the pt go see their primary and > > confirm the dx and get a > > referral from them. > > > > Todd Mourning, PT > > > > Abraham Lincoln Memorial Hospital > > Lincoln, IL > > > > ________________________________ > > From: PTManager > > <mailto:PTManager%40yahoogroups.com> > > [mailto:PTManager > > <mailto:PTManager%40yahoogroups.com> ] > > On Behalf Of Rhoda Astronomo > > Sent: Monday, January 21, 2008 5:42 PM > > To: PTManager > > <mailto:PTManager%40yahoogroups.com> > > Subject: RE: chiropractors > > > > Jeff, > > > > I am also in Illinois.. and as I read the IL > > Practice act regarding > > referral.. it states: > > > > (6) " Referral " means a written or oral > authorization > > for physical > > therapy > > services for a patient by a physician, dentist, > > advanced practice nurse, > > physician assistant, or podiatrist who maintains > > medical supervision of > > the > > patient and makes a diagnosis or verifies that the > > patient's condition > > is > > such that it may be treated by a physical > therapist. > > > > Here is the link: > > > > Illinois Physical Therapy Practice Act. Illinois > > General Assembly. > > Retrieved 1/21/08 from > > > http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 > > > <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319> > > > > > <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 & ChapAct=225%26nbs > > p%3B > > > <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 & ChapAct=225%26nbs > > p%3B> > > ILCS%26nbsp%3B90%2F & Chap> > > & ChapAct=225%26nbsp%3BILCS%26nbsp%3B90%2F & Chap > > > > I do not see Chiropractors anywhere in our > practice > > act. Could you > > please > > let me know where you find your statement " The > > Illinios Physical Therapy > > Assoc. states that our Practice Act allows for > PT's > > to eval/treat from > > Chiropractic referrals " ? > > > > Thanks. > > > > Rhoda Astronomo, PT > > > > President > > > > R.A. Physical Therapy, PC > > > > Gibson City, IL > > > > > > > > From: PTManager > > <mailto:PTManager%40yahoogroups.com> > > <mailto:PTManager%40yahoogroups.com> > > [mailto:PTManager > > <mailto:PTManager%40yahoogroups.com> > > <mailto:PTManager%40yahoogroups.com>] On Behalf > > Of BROWN,JEFF > > Sent: Monday, January 21, 2008 4:20 PM > > To: ptmanager > > <mailto:ptmanager%40yahoogroups.com> > > <mailto:ptmanager%40yahoogroups.com> > > Subject: Re: chiropractors > > > > Jeff, > > The Illinios Physical Therapy Assoc. states that > our > > Practice Act allows > > for > > PT's to eval/treat from Chiropractic referrals. > This > > has been all that > > we > > have needed to see these patients in our hospital > > system. As far as the > > reimbursement issue there have been so few that I > > have not gotten word > > from > > our business office as to not having coverage. > > > > The one thing I have been most concerned about is > > the dual treatment of > > our > > service and the chiropractors treatment. My > personal > > experience is that > > this > > has not been very successful. I have found more > > often than not that my > > plan > > of care has been altered, added too, or negated. > > > > Take this for what it is worth. > > > > Jeff Brown PT > > Director of Rehabilitation > > Decatur Memorial Hospital > > Decatur, Illinois > > > > >>> jeff nolder <nolderj@... > > <mailto:nolderj%40hotmail.com> > > <mailto:nolderj%40hotmail.com> > > <mailto:nolderj%40hotmail.com> > > > 01/21/08 3:20 PM >>> > > > > Hello group, we are a small town hospital with > three > > chiropractic > > clinics in > > town. We have recently seen an increase in > referrals > > from chiropractic > === message truncated === ________________________________________________________________________________\ ____ Never miss a thing. Make Yahoo your home page. http://www.yahoo.com/r/hs Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 6, 2008 Report Share Posted February 6, 2008 There are other issues at hand as well. How can you control what another professional, especially one not in the same clinic, is doing? I'm not implying that it would even be negligent. But two of the same thing does not provide twice the results. Often times it's too much. If I perform a treatment I do so with a confidence and predictability that it is going to be effective, and this is based on both my scientific knowledge of what I'm doing AND my experience with past patients. We all know that as good intentioned as patients may be they often times are not accurate historians on what another clinician is doing with them. And I know we could get the documentation from the chiropractor but I want to know how my treatment plan is affecting a patient without the input of another clinician possibly doing some of the same things. Did I do too much exercise?, would High-volt be more effective than Interferential?, was my mobilization grade too vigorous? How could I really know if a chiropractor may be doing the same thing? I am not anti chiropractic. I have had too many patients tell me they responded well to their chiropractic plan of care to argue with this. We think differently, variety is the spice of life. The point we all have to cognizant of is that we are held liable for what we are doing. Why live with an unknown when you don't have to. It is only smart to NOT treat someone who is actively receiving chiropractic care. Explain your reasoning to the patient and give them the choice between chiropracic and PT. This has never gotten me into trouble. My 2 cents. Jeff Brown PT Director of Rehabilitation Decatur Memorial Hospital Decatur, Ill >>> Schweitzer 02/06/08 7:06 AM >>> PT and chiropractic are not similar. They are 2 distinct professions with distinct bodies of knowledge. Without being schooled as a chiro, how do you even know what they know? 2 professions with 2 different viewpoints can both benefit a patient at the same time. Even 2 PTs collaborating in a single clinic can benefit a single patient..Why not another professional? Its tiring to hear so many of my fellow PT collegues be so negative to another medical profession. Just do your best work and let the rest unfold. Cheeers, keith bisesi wrote: It's not really an evidence based practice or research based comment. It's simply not necessary. If you're seeking two similar treatment options, how do you know which is helping? I wouldn't have two mechanics co-repair my car's engine. It would be similar to an MD referring a patient to an OT and to a PT for a wrist injury - I would advise a patient to see one or the other. Regarding the chiropractic referral example, I would have the patient begin PT when the chiropractic care was complete. I wouldn't try to take the patient away from the chiro who referred him/her. Bisesi MPT COMT Winter Haven, Fl --- Schweitzer wrote: > There is no evidence that I know of in the > literature that co-treating a patient with another > manual-based clinican such as a chiropractor is > detrimental to the patient. > > Schweitzer > > " Dogma is the curse of learning. " - Laurie Hartman > > > > keith bisesi wrote: > I completely agree. I posted a similar > opinion a few > weeks ago. I often see chiropractors refer to us > assuming we are to perform the exercise portion of > rehab while they do the manual work. I always advise > my patients to not do both chiropractic and physical > therapy simultaneously. > > Bisesi MPT COMT > Winter Haven, Fl > > --- Stanley Paris wrote: > > > Here's my take. If you are going to treat a > patient > > referred from a > > chiropractor make sure its a referral and that you > > are responsible for > > the evaluation and the treatment that follows and > > that during this > > period the chiropractor is not engaged in treating > > the patient. Do not > > accept a prescription for modalities especially > > while the chiropractor > > continues with his/her administrations. > > Stanley Paris > > > > ________________________________ > > > > From: PTManager > > [mailto:PTManager ] On > > Behalf Of Mourning, Todd > > Sent: Tuesday, January 22, 2008 9:48 AM > > To: 'PTManager ' > > Subject: RE: chiropractors > > > > > > > > We have been under the impression that since > Chiro's > > are listed as Chiro > > Physician, we do have the ability to see them. > > Doesn't happen very much > > in Lincoln but if it does, we usually do see them. > > We will generally > > recommend that the pt go see their primary and > > confirm the dx and get a > > referral from them. > > > > Todd Mourning, PT > > > > Abraham Lincoln Memorial Hospital > > Lincoln, IL > > > > ________________________________ > > From: PTManager > > <mailto:PTManager%40yahoogroups.com> > > [mailto:PTManager > > <mailto:PTManager%40yahoogroups.com> ] > > On Behalf Of Rhoda Astronomo > > Sent: Monday, January 21, 2008 5:42 PM > > To: PTManager > > <mailto:PTManager%40yahoogroups.com> > > Subject: RE: chiropractors > > > > Jeff, > > > > I am also in Illinois.. and as I read the IL > > Practice act regarding > > referral.. it states: > > > > (6) " Referral " means a written or oral > authorization > > for physical > > therapy > > services for a patient by a physician, dentist, > > advanced practice nurse, > > physician assistant, or podiatrist who maintains > > medical supervision of > > the > > patient and makes a diagnosis or verifies that the > > patient's condition > > is > > such that it may be treated by a physical > therapist. > > > > Here is the link: > > > > Illinois Physical Therapy Practice Act. Illinois > > General Assembly. > > Retrieved 1/21/08 from > > > http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 > > > <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319> > > > > > <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 & ChapAct=225%26nbs > > p%3B > > > <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 & ChapAct=225%26nbs > > p%3B> > > ILCS%26nbsp%3B90%2F & Chap> > > & ChapAct=225%26nbsp%3BILCS%26nbsp%3B90%2F & Chap > > > > I do not see Chiropractors anywhere in our > practice > > act. Could you > > please > > let me know where you find your statement " The > > Illinios Physical Therapy > > Assoc. states that our Practice Act allows for > PT's > > to eval/treat from > > Chiropractic referrals " ? > > > > Thanks. > > > > Rhoda Astronomo, PT > > > > President > > > > R.A. Physical Therapy, PC > > > > Gibson City, IL > > > > > > > > From: PTManager > > <mailto:PTManager%40yahoogroups.com> > > <mailto:PTManager%40yahoogroups.com> > > [mailto:PTManager > > <mailto:PTManager%40yahoogroups.com> > > <mailto:PTManager%40yahoogroups.com>] On Behalf > > Of BROWN,JEFF > > Sent: Monday, January 21, 2008 4:20 PM > > To: ptmanager > > <mailto:ptmanager%40yahoogroups.com> > > <mailto:ptmanager%40yahoogroups.com> > > Subject: Re: chiropractors > > > > Jeff, > > The Illinios Physical Therapy Assoc. states that > our > > Practice Act allows > > for > > PT's to eval/treat from Chiropractic referrals. > This > > has been all that > > we > > have needed to see these patients in our hospital > > system. As far as the > > reimbursement issue there have been so few that I > > have not gotten word > > from > > our business office as to not having coverage. > > > > The one thing I have been most concerned about is > > the dual treatment of > > our > > service and the chiropractors treatment. My > personal > > experience is that > > this > > has not been very successful. I have found more > > often than not that my > > plan > > of care has been altered, added too, or negated. > > > > Take this for what it is worth. > > > > Jeff Brown PT > > Director of Rehabilitation > > Decatur Memorial Hospital > > Decatur, Illinois > > > > >>> jeff nolder <nolderj@... > > <mailto:nolderj%40hotmail.com> > > <mailto:nolderj%40hotmail.com> > > <mailto:nolderj%40hotmail.com> > > > 01/21/08 3:20 PM >>> > > > > Hello group, we are a small town hospital with > three > > chiropractic > > clinics in > > town. We have recently seen an increase in > referrals > > from chiropractic > === message truncated === __________________________________________________________ Never miss a thing. Make Yahoo your home page. http://www.yahoo.com/r/hs --------------------------------- Be a better friend, newshound, and know-it-all with Yahoo! Mobile. Try it now. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 6, 2008 Report Share Posted February 6, 2008 , Could you please provide your background for us as this may help in understanding your defense of chiropractors. I happen to agree with Dr. Paris and other postings that if a patient is being treated by a chiro and the same time as PT then you do not know what is helping and what is not. What happens if the patient sees you and you give them some new stretches/ex's to do at home, but before they return to see you they go to a chiro for an 'adjustment' and then come back in a worsened condition than before? Is this due to what you prescribed them or is it from the chiro treatment? If we are to sustain our professsion then we need to continually work on educating ourselves, the patient, referral sources, etc of what we truly are capable of doing. I feel that if we automatically defer to other healthcare providers for their understanding and assessment of a problem than it will be difficult to move forward as a profession, no matter what initial follow our names. My 2 cents... Gwilliam, PT, CWS > > > > > Here's my take. If you are going to treat a > > patient > > > referred from a > > > chiropractor make sure its a referral and that you > > > are responsible for > > > the evaluation and the treatment that follows and > > > that during this > > > period the chiropractor is not engaged in treating > > > the patient. Do not > > > accept a prescription for modalities especially > > > while the chiropractor > > > continues with his/her administrations. > > > Stanley Paris > > > > > > ________________________________ > > > > > > From: PTManager > > > [mailto:PTManager ] On > > > Behalf Of Mourning, Todd > > > Sent: Tuesday, January 22, 2008 9:48 AM > > > To: 'PTManager ' > > > Subject: RE: chiropractors > > > > > > > > > > > > We have been under the impression that since > > Chiro's > > > are listed as Chiro > > > Physician, we do have the ability to see them. > > > Doesn't happen very much > > > in Lincoln but if it does, we usually do see them. > > > We will generally > > > recommend that the pt go see their primary and > > > confirm the dx and get a > > > referral from them. > > > > > > Todd Mourning, PT > > > > > > Abraham Lincoln Memorial Hospital > > > Lincoln, IL > > > > > > ________________________________ > > > From: PTManager > > > <mailto:PTManager%40yahoogroups.com> > > > [mailto:PTManager > > > <mailto:PTManager%40yahoogroups.com> ] > > > On Behalf Of Rhoda Astronomo > > > Sent: Monday, January 21, 2008 5:42 PM > > > To: PTManager > > > <mailto:PTManager%40yahoogroups.com> > > > Subject: RE: chiropractors > > > > > > Jeff, > > > > > > I am also in Illinois.. and as I read the IL > > > Practice act regarding > > > referral.. it states: > > > > > > (6) " Referral " means a written or oral > > authorization > > > for physical > > > therapy > > > services for a patient by a physician, dentist, > > > advanced practice nurse, > > > physician assistant, or podiatrist who maintains > > > medical supervision of > > > the > > > patient and makes a diagnosis or verifies that the > > > patient's condition > > > is > > > such that it may be treated by a physical > > therapist. > > > > > > Here is the link: > > > > > > Illinois Physical Therapy Practice Act. Illinois > > > General Assembly. > > > Retrieved 1/21/08 from > > > > > > http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 > > > > > > <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319> > > > > > > > > > <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 & ChapAct=225% 26nbs > > > p%3B > > > > > > <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 & ChapAct=225% 26nbs > > > p%3B> > > > ILCS%26nbsp%3B90%2F & Chap> > > > & ChapAct=225%26nbsp%3BILCS%26nbsp%3B90%2F & Chap > > > > > > I do not see Chiropractors anywhere in our > > practice > > > act. Could you > > > please > > > let me know where you find your statement " The > > > Illinios Physical Therapy > > > Assoc. states that our Practice Act allows for > > PT's > > > to eval/treat from > > > Chiropractic referrals " ? > > > > > > Thanks. > > > > > > Rhoda Astronomo, PT > > > > > > President > > > > > > R.A. Physical Therapy, PC > > > > > > Gibson City, IL > > > > > > > > > > > > From: PTManager > > > <mailto:PTManager%40yahoogroups.com> > > > <mailto:PTManager%40yahoogroups.com> > > > [mailto:PTManager > > > <mailto:PTManager%40yahoogroups.com> > > > <mailto:PTManager%40yahoogroups.com>] On Behalf > > > Of BROWN,JEFF > > > Sent: Monday, January 21, 2008 4:20 PM > > > To: ptmanager > > > <mailto:ptmanager%40yahoogroups.com> > > > <mailto:ptmanager%40yahoogroups.com> > > > Subject: Re: chiropractors > > > > > > Jeff, > > > The Illinios Physical Therapy Assoc. states that > > our > > > Practice Act allows > > > for > > > PT's to eval/treat from Chiropractic referrals. > > This > > > has been all that > > > we > > > have needed to see these patients in our hospital > > > system. As far as the > > > reimbursement issue there have been so few that I > > > have not gotten word > > > from > > > our business office as to not having coverage. > > > > > > The one thing I have been most concerned about is > > > the dual treatment of > > > our > > > service and the chiropractors treatment. My > > personal > > > experience is that > > > this > > > has not been very successful. I have found more > > > often than not that my > > > plan > > > of care has been altered, added too, or negated. > > > > > > Take this for what it is worth. > > > > > > Jeff Brown PT > > > Director of Rehabilitation > > > Decatur Memorial Hospital > > > Decatur, Illinois > > > > > > >>> jeff nolder <nolderj@... > > > <mailto:nolderj%40hotmail.com> > > > <mailto:nolderj%40hotmail.com> > > > <mailto:nolderj%40hotmail.com> > > > > 01/21/08 3:20 PM >>> > > > > > > Hello group, we are a small town hospital with > > three > > > chiropractic > > > clinics in > > > town. We have recently seen an increase in > > referrals > > > from chiropractic > > > === message truncated === > > __________________________________________________________ > Never miss a thing. Make Yahoo your home page. > http://www.yahoo.com/r/hs > > > > > > > --------------------------------- > Be a better friend, newshound, and know-it-all with Yahoo! Mobile. Try it now. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 6, 2008 Report Share Posted February 6, 2008 , Please don't call chiropractic care " another medical profession " . This comment is not a criticism of the profession; its statement that they function outside the medical model. Chiropractic care is a form of alternative care similar to acupunture. Two PTs collaborating in a single clinic is not analogous to a patient receiving PT and chiro at the same time. 's example of the OT and PT treatment of the wrist is more precise. Have you performed manual techniques on a patient who underwent chiropractic adjustment on the same day? If you have, did you have difficulty discerning the variables responsible for the objective outcome. You should have... because the results were obscured by an uncontrolled variable. I also wouldn't have a patient with lumbar instability initiate a group Pilates class at the local gym while I am trying to educate her into TA/IO recruitment progression. If we don't define our profession, then someone else will... -chris >>> Schweitzer 02/06/2008 05:06 >>> PT and chiropractic are not similar. They are 2 distinct professions with distinct bodies of knowledge. Without being schooled as a chiro, how do you even know what they know? 2 professions with 2 different viewpoints can both benefit a patient at the same time. Even 2 PTs collaborating in a single clinic can benefit a single patient..Why not another professional? Its tiring to hear so many of my fellow PT collegues be so negative to another medical profession. Just do your best work and let the rest unfold. Cheeers, keith bisesi wrote: It's not really an evidence based practice or research based comment. It's simply not necessary. If you're seeking two similar treatment options, how do you know which is helping? I wouldn't have two mechanics co-repair my car's engine. It would be similar to an MD referring a patient to an OT and to a PT for a wrist injury - I would advise a patient to see one or the other. Regarding the chiropractic referral example, I would have the patient begin PT when the chiropractic care was complete. I wouldn't try to take the patient away from the chiro who referred him/her. Bisesi MPT COMT Winter Haven, Fl --- Schweitzer wrote: > There is no evidence that I know of in the > literature that co-treating a patient with another > manual-based clinican such as a chiropractor is > detrimental to the patient. > > Schweitzer > > " Dogma is the curse of learning. " - Laurie Hartman > > > > keith bisesi wrote: > I completely agree. I posted a similar > opinion a few > weeks ago. I often see chiropractors refer to us > assuming we are to perform the exercise portion of > rehab while they do the manual work. I always advise > my patients to not do both chiropractic and physical > therapy simultaneously. > > Bisesi MPT COMT > Winter Haven, Fl > > --- Stanley Paris wrote: > > > Here's my take. If you are going to treat a > patient > > referred from a > > chiropractor make sure its a referral and that you > > are responsible for > > the evaluation and the treatment that follows and > > that during this > > period the chiropractor is not engaged in treating > > the patient. Do not > > accept a prescription for modalities especially > > while the chiropractor > > continues with his/her administrations. > > Stanley Paris > > > > ________________________________ > > > > From: PTManager > > [mailto:PTManager ] On > > Behalf Of Mourning, Todd > > Sent: Tuesday, January 22, 2008 9:48 AM > > To: 'PTManager ' > > Subject: RE: chiropractors > > > > > > > > We have been under the impression that since > Chiro's > > are listed as Chiro > > Physician, we do have the ability to see them. > > Doesn't happen very much > > in Lincoln but if it does, we usually do see them. > > We will generally > > recommend that the pt go see their primary and > > confirm the dx and get a > > referral from them. > > > > Todd Mourning, PT > > > > Abraham Lincoln Memorial Hospital > > Lincoln, IL > > > > ________________________________ > > From: PTManager > > <mailto:PTManager%40yahoogroups.com> > > [mailto:PTManager > > <mailto:PTManager%40yahoogroups.com> ] > > On Behalf Of Rhoda Astronomo > > Sent: Monday, January 21, 2008 5:42 PM > > To: PTManager > > <mailto:PTManager%40yahoogroups.com> > > Subject: RE: chiropractors > > > > Jeff, > > > > I am also in Illinois.. and as I read the IL > > Practice act regarding > > referral.. it states: > > > > (6) " Referral " means a written or oral > authorization > > for physical > > therapy > > services for a patient by a physician, dentist, > > advanced practice nurse, > > physician assistant, or podiatrist who maintains > > medical supervision of > > the > > patient and makes a diagnosis or verifies that the > > patient's condition > > is > > such that it may be treated by a physical > therapist. > > > > Here is the link: > > > > Illinois Physical Therapy Practice Act. Illinois > > General Assembly. > > Retrieved 1/21/08 from > > > http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 > > > <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319> > > > > > <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 & ChapAct=225%26nbs > > p%3B > > > <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 & ChapAct=225%26nbs > > p%3B> > > ILCS%26nbsp%3B90%2F & Chap> > > & ChapAct=225%26nbsp%3BILCS%26nbsp%3B90%2F & Chap > > > > I do not see Chiropractors anywhere in our > practice > > act. Could you > > please > > let me know where you find your statement " The > > Illinios Physical Therapy > > Assoc. states that our Practice Act allows for > PT's > > to eval/treat from > > Chiropractic referrals " ? > > > > Thanks. > > > > Rhoda Astronomo, PT > > > > President > > > > R.A. Physical Therapy, PC > > > > Gibson City, IL > > > > > > > > From: PTManager > > <mailto:PTManager%40yahoogroups.com> > > <mailto:PTManager%40yahoogroups.com> > > [mailto:PTManager > > <mailto:PTManager%40yahoogroups.com> > > <mailto:PTManager%40yahoogroups.com>] On Behalf > > Of BROWN,JEFF > > Sent: Monday, January 21, 2008 4:20 PM > > To: ptmanager > > <mailto:ptmanager%40yahoogroups.com> > > <mailto:ptmanager%40yahoogroups.com> > > Subject: Re: chiropractors > > > > Jeff, > > The Illinios Physical Therapy Assoc. states that > our > > Practice Act allows > > for > > PT's to eval/treat from Chiropractic referrals. > This > > has been all that > > we > > have needed to see these patients in our hospital > > system. As far as the > > reimbursement issue there have been so few that I > > have not gotten word > > from > > our business office as to not having coverage. > > > > The one thing I have been most concerned about is > > the dual treatment of > > our > > service and the chiropractors treatment. My > personal > > experience is that > > this > > has not been very successful. I have found more > > often than not that my > > plan > > of care has been altered, added too, or negated. > > > > Take this for what it is worth. > > > > Jeff Brown PT > > Director of Rehabilitation > > Decatur Memorial Hospital > > Decatur, Illinois > > > > >>> jeff nolder <nolderj@... > > <mailto:nolderj%40hotmail.com> > > <mailto:nolderj%40hotmail.com> > > <mailto:nolderj%40hotmail.com> > > > 01/21/08 3:20 PM >>> > > > > Hello group, we are a small town hospital with > three > > chiropractic > > clinics in > > town. We have recently seen an increase in > referrals > > from chiropractic > === message truncated === __________________________________________________________ Never miss a thing. Make Yahoo your home page. http://www.yahoo.com/r/hs --------------------------------- Be a better friend, newshound, and know-it-all with Yahoo! Mobile. Try it now. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 6, 2008 Report Share Posted February 6, 2008 I don't believe 's response was negative in any way. Therapy is more than a random lot of treatments thrown at a problem and hoping for the best. Evaluating how my patients are responding and adjusting their treatments accordingly is part of my routine treatment plan. Receiving 2 distinct treatment plans doesnt work for me be it 2 PT plans, a PT and an OT plan, or PT and Chiro. If the treatments are coordinated then I can often work it out. This is rare and very time consuming unless you are in the same clinic. Otherwise I prefer to ask my patients to choose a type of treatment. If they insist on doing both I don't discharge them, but I do insist that they keep me informed on how they are responding to the other treatments. Marino, PT, OCS, CertMDT, CSCS Axiom Physical Therapy Marietta, Ga --------- Re: chiropractors > > > > Jeff, > > The Illinios Physical Therapy Assoc. states that > our > > Practice Act allows > > for > > PT's to eval/treat from Chiropractic referrals. > This > > has been all that > > we > > have needed to see these patients in our hospital > > system. As far as the > > reimbursement issue there have been so few that I > > have not gotten word > > from > > our business office as to not having coverage. > > > > The one thing I have been most concerned about is > > the dual treatment of > > our > > service and the chiropractors treatment. My > personal > > experience is that > > this > > has not been very successful. I have found more > > often than not that my > > plan > > of care has been altered, added too, or negated. > > > > Take this for what it is worth. > > > > Jeff Brown PT > > Director of Rehabilitation > > Decatur Memorial Hospital > > Decatur, Illinois > > > > >>> jeff nolder <nolderj@... > > <mailto:nolderj%40hotmail.com> > > <mailto:nolderj%40hotmail.com> > > <mailto:nolderj%40hotmail.com> > > > 01/21/08 3:20 PM >>> > > > > Hello group, we are a small town hospital with > three > > chiropractic > > clinics in > > town. We have recently seen an increase in > referrals > > from chiropractic > === message truncated === __________________________________________________________ Never miss a thing. Make Yahoo your home page. http://www.yahoo.com/r/hs --------------------------------- Be a better friend, newshound, and know-it-all with Yahoo! Mobile. Try it now. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 6, 2008 Report Share Posted February 6, 2008 , there is documentation in the literature of pts. dying secondary to upper cervical manipulations. I think the problem arises when something detrimental happens and two people are performing similar treatments, who is at fault? Do you want to trust that the chiro would take responsibility, do you want to trust that he/she is following all the proper precautions, do you want to perform upper cervical stabilization on a patient just after he/she had an upper cervical manip that maybe didnt go so well at the chiro's? I think these are all legitimate concerns that contraindicate co-treatment. E. s, PT, DPT, OCS, FAAOMPT www.douglasspt.com > > > Here's my take. If you are going to treat a patient > > referred from a > > chiropractor make sure its a referral and that you > > are responsible for > > the evaluation and the treatment that follows and > > that during this > > period the chiropractor is not engaged in treating > > the patient. Do not > > accept a prescription for modalities especially > > while the chiropractor > > continues with his/her administrations. > > Stanley Paris > > > > ________________________________ > > > > From: PTManager > > [mailto:PTManager ] On > > Behalf Of Mourning, Todd > > Sent: Tuesday, January 22, 2008 9:48 AM > > To: 'PTManager ' > > Subject: RE: chiropractors > > > > > > > > We have been under the impression that since Chiro's > > are listed as Chiro > > Physician, we do have the ability to see them. > > Doesn't happen very much > > in Lincoln but if it does, we usually do see them. > > We will generally > > recommend that the pt go see their primary and > > confirm the dx and get a > > referral from them. > > > > Todd Mourning, PT > > > > Abraham Lincoln Memorial Hospital > > Lincoln, IL > > > > ________________________________ > > From: PTManager > > <mailto:PTManager%40yahoogroups.com> > > [mailto:PTManager > > <mailto:PTManager%40yahoogroups.com> ] > > On Behalf Of Rhoda Astronomo > > Sent: Monday, January 21, 2008 5:42 PM > > To: PTManager > > <mailto:PTManager%40yahoogroups.com> > > Subject: RE: chiropractors > > > > Jeff, > > > > I am also in Illinois.. and as I read the IL > > Practice act regarding > > referral.. it states: > > > > (6) " Referral " means a written or oral authorization > > for physical > > therapy > > services for a patient by a physician, dentist, > > advanced practice nurse, > > physician assistant, or podiatrist who maintains > > medical supervision of > > the > > patient and makes a diagnosis or verifies that the > > patient's condition > > is > > such that it may be treated by a physical therapist. > > > > Here is the link: > > > > Illinois Physical Therapy Practice Act. Illinois > > General Assembly. > > Retrieved 1/21/08 from > > > http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 > > > <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319> > > > > > <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 & ChapAct=225% 26nbs > > p%3B > > > <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 & ChapAct=225% 26nbs > > p%3B> > > ILCS%26nbsp%3B90%2F & Chap> > > & ChapAct=225%26nbsp%3BILCS%26nbsp%3B90%2F & Chap > > > > I do not see Chiropractors anywhere in our practice > > act. Could you > > please > > let me know where you find your statement " The > > Illinios Physical Therapy > > Assoc. states that our Practice Act allows for PT's > > to eval/treat from > > Chiropractic referrals " ? > > > > Thanks. > > > > Rhoda Astronomo, PT > > > > President > > > > R.A. Physical Therapy, PC > > > > Gibson City, IL > > > > > > > > From: PTManager > > <mailto:PTManager%40yahoogroups.com> > > <mailto:PTManager%40yahoogroups.com> > > [mailto:PTManager > > <mailto:PTManager%40yahoogroups.com> > > <mailto:PTManager%40yahoogroups.com>] On Behalf > > Of BROWN,JEFF > > Sent: Monday, January 21, 2008 4:20 PM > > To: ptmanager > > <mailto:ptmanager%40yahoogroups.com> > > <mailto:ptmanager%40yahoogroups.com> > > Subject: Re: chiropractors > > > > Jeff, > > The Illinios Physical Therapy Assoc. states that our > > Practice Act allows > > for > > PT's to eval/treat from Chiropractic referrals. This > > has been all that > > we > > have needed to see these patients in our hospital > > system. As far as the > > reimbursement issue there have been so few that I > > have not gotten word > > from > > our business office as to not having coverage. > > > > The one thing I have been most concerned about is > > the dual treatment of > > our > > service and the chiropractors treatment. My personal > > experience is that > > this > > has not been very successful. I have found more > > often than not that my > > plan > > of care has been altered, added too, or negated. > > > > Take this for what it is worth. > > > > Jeff Brown PT > > Director of Rehabilitation > > Decatur Memorial Hospital > > Decatur, Illinois > > > > >>> jeff nolder <nolderj@... > > <mailto:nolderj%40hotmail.com> > > <mailto:nolderj%40hotmail.com> > > <mailto:nolderj%40hotmail.com> > > > 01/21/08 3:20 PM >>> > > > > Hello group, we are a small town hospital with three > > chiropractic > > clinics in > > town. We have recently seen an increase in referrals > > from chiropractic > > offices. In the past we have not allowed these and > > need a referral from > > a > > family doc to treat. We have found that most of > > these patients will not > > go > > to the family doc and are just staying with the > > chiropractors. We would > > like > > to be able to see these patients and do not want to > > exclude a referral > > source. Our policy at the hosiptal is that every > > pateint needs to have a > > doctors referral to be seen. I would like to see > > these patients but > > unsure > > how to go about doing this? Secondary to liability > > issues and payment > > issues > > for multiple insurances, do anyone have a good > > solutions or ideas how to > > fix > > this problem? thanks for the help > > > > Jeff Nolder, PT > > Director of Physical Medicine and Rehab > > Cherokee Regional Medical Center > > > > > __________________________________________________________ > > Climb to the top of the charts! Play the word > > scramble challenge with > > star > > power. > > > http://club.live.com/star_shuffle.aspx? icid=starshuffle_wlmailtextlink_j > > an > > > <http://club.live.com/star_shuffle.aspx? icid=starshuffle_wlmailtextlink_ > > jan> > > > > [Non-text portions of this message have been > > removed] > > > === message truncated === > > __________________________________________________________ > Never miss a thing. Make Yahoo your home page. > http://www.yahoo.com/r/hs > > > > > > > --------------------------------- > Never miss a thing. Make Yahoo your homepage. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 6, 2008 Report Share Posted February 6, 2008 , I appreciate your positive outlook but I have to disagree. PT and chiro interventions are remarkably similar, despite our philosophies being quite different. If we weren't similar, chiro's wouldn't be suing PT's for performing spine mobilizations. Causing even further similarities with our professions, is chiropractors abandoning their old school of thought that manipulations are a panacea for everything and now including exercise programs prominently in their treatment plans much of the time. Unfortunately the lines are defined between PT and chiropractic, as with PT and athletic trainers and massage therapists. It's not one sided disdain. Our fields could interact and collaborate better, but overall we see each other as a threat. It is what it is. Bisesi Winter Haven, Fl. --- Schweitzer wrote: > PT and chiropractic are not similar. They are 2 > distinct professions with distinct bodies of > knowledge. Without being schooled as a chiro, how > do you even know what they know? > 2 professions with 2 different viewpoints can both > benefit a patient at the same time. Even 2 PTs > collaborating in a single clinic can benefit a > single patient..Why not another professional? > Its tiring to hear so many of my fellow PT > collegues be so negative to another medical > profession. > Just do your best work and let the rest unfold. > Cheeers, > > > > keith bisesi wrote: > It's not really an evidence based practice > or research > based comment. It's simply not necessary. If you're > seeking two similar treatment options, how do you > know > which is helping? I wouldn't have two mechanics > co-repair my car's engine. It would be similar to an > MD referring a patient to an OT and to a PT for a > wrist injury - I would advise a patient to see one > or > the other. Regarding the chiropractic referral > example, I would have the patient begin PT when the > chiropractic care was complete. I wouldn't try to > take > the patient away from the chiro who referred > him/her. > > Bisesi MPT COMT > Winter Haven, Fl > > --- Schweitzer > wrote: > > > There is no evidence that I know of in the > > literature that co-treating a patient with another > > manual-based clinican such as a chiropractor is > > detrimental to the patient. > > > > Schweitzer > > > > " Dogma is the curse of learning. " - Laurie Hartman > > > > > > > > keith bisesi wrote: > > I completely agree. I posted a similar > > opinion a few > > weeks ago. I often see chiropractors refer to us > > assuming we are to perform the exercise portion of > > rehab while they do the manual work. I always > advise > > my patients to not do both chiropractic and > physical > > therapy simultaneously. > > > > Bisesi MPT COMT > > Winter Haven, Fl > > > > --- Stanley Paris wrote: > > > > > Here's my take. If you are going to treat a > > patient > > > referred from a > > > chiropractor make sure its a referral and that > you > > > are responsible for > > > the evaluation and the treatment that follows > and > > > that during this > > > period the chiropractor is not engaged in > treating > > > the patient. Do not > > > accept a prescription for modalities especially > > > while the chiropractor > > > continues with his/her administrations. > > > Stanley Paris > > > > > > ________________________________ > > > > > > From: PTManager > > > [mailto:PTManager ] On > > > Behalf Of Mourning, Todd > > > Sent: Tuesday, January 22, 2008 9:48 AM > > > To: 'PTManager ' > > > Subject: RE: chiropractors > > > > > > > > > > > > We have been under the impression that since > > Chiro's > > > are listed as Chiro > > > Physician, we do have the ability to see them. > > > Doesn't happen very much > > > in Lincoln but if it does, we usually do see > them. > > > We will generally > > > recommend that the pt go see their primary and > > > confirm the dx and get a > > > referral from them. > > > > > > Todd Mourning, PT > > > > > > Abraham Lincoln Memorial Hospital > > > Lincoln, IL > > > > > > ________________________________ > > > From: PTManager > > > <mailto:PTManager%40yahoogroups.com> > > > [mailto:PTManager > > > <mailto:PTManager%40yahoogroups.com> ] > > > On Behalf Of Rhoda Astronomo > > > Sent: Monday, January 21, 2008 5:42 PM > > > To: PTManager > > > <mailto:PTManager%40yahoogroups.com> > > > Subject: RE: chiropractors > > > > > > Jeff, > > > > > > I am also in Illinois.. and as I read the IL > > > Practice act regarding > > > referral.. it states: > > > > > > (6) " Referral " means a written or oral > > authorization > > > for physical > > > therapy > > > services for a patient by a physician, dentist, > > > advanced practice nurse, > > > physician assistant, or podiatrist who maintains > > > medical supervision of > > > the > > > patient and makes a diagnosis or verifies that > the > > > patient's condition > > > is > > > such that it may be treated by a physical > > therapist. > > > > > > Here is the link: > > > > > > Illinois Physical Therapy Practice Act. Illinois > > > General Assembly. > > > Retrieved 1/21/08 from > > > > > > http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 > > > > > > <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319> > > > > > > > > > <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 & ChapAct=225%26nbs > > > p%3B > > > > > > <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 & ChapAct=225%26nbs > > > p%3B> > > > ILCS%26nbsp%3B90%2F & Chap> > > > & ChapAct=225%26nbsp%3BILCS%26nbsp%3B90%2F & Chap > > > > > > I do not see Chiropractors anywhere in our > > practice > > > act. Could you > > > please > > > let me know where you find your statement " The > > > Illinios Physical Therapy > > > Assoc. states that our Practice Act allows for > > PT's > > > to eval/treat from > > > Chiropractic referrals " ? > > > > > > Thanks. > > > > > > Rhoda Astronomo, PT > > > > > > President > > > > > > R.A. Physical Therapy, PC > > > > > > Gibson City, IL > > > > > > > > > > > > From: PTManager > > > <mailto:PTManager%40yahoogroups.com> > > > <mailto:PTManager%40yahoogroups.com> > > > [mailto:PTManager > > > <mailto:PTManager%40yahoogroups.com> > > > <mailto:PTManager%40yahoogroups.com>] On Behalf > > > Of BROWN,JEFF > > > Sent: Monday, January 21, 2008 4:20 PM > > > To: ptmanager > > > <mailto:ptmanager%40yahoogroups.com> > === message truncated === ________________________________________________________________________________\ ____ Never miss a thing. Make Yahoo your home page. http://www.yahoo.com/r/hs Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 7, 2008 Report Share Posted February 7, 2008 " We also get referrals for just physical therapy so this model of referrals is one of many. " What is " just physical therapy " ? saying that does not help the profession at all. You are basically taking our manual skills away. Physical Therapy includes all types of treatment, INCLUDING manual. Manips when needed. Why are you settling for someone saying just PT. How do you know what therapeutic exercise to do if you do not have a feel for what is going on to their body. Are you just a personal trainer? BRYAN RUCHIN, PT, DPT Atlanta Rehabilitation and Performance Center 1735 Buford Highway, Ste. 310 Cumming, Ga. 30041 - Office - Fax bruchin@... www.atlantarehab.com <http://www.atlantarehab.com/> chiropractors Hi everyone, Let me offer an additional perspective on chiropractors and dual treatment. Idaho is a full direct access state so we get referrals from many sources. One source is third party cases (ie auto accidents) through managing physicians who often refer clients to both a chiropractor and a physical therapist. The chiropractor most often does just spinal adjustments and the therapists then will do any soft tissue and exercises. This will vary depending on the chiropractor and the therapists involved. We also get referrals for just physical therapy so this model of referrals is one of many. Now before getting upset at this model, let me tell you that we have tried educating the managing physicians that this is an unnecessary waste of time but that has been unsuccessful. We could have refused business on principle but we looked at it another way. 1. We have the opportunity to treat clients that needed our help. 2. We have the opportunity to educate them on the differences between the professions and let them decide what worked best for them. 3. We have the opportunity to work with chiropractors in a positive way, coordinating care and addressing concerns in a way that educates them on what we do as well 4. We create relationships with chiropractors that develop into positive referral relationships as well 5. We create better understanding among the chiropractors of what we do. This came in handy in 2001 when we revised our practice act and were able to maintain the term " manipulation " in our practice act giving us full manual therapy abilities without restriction. In my opinion, there is nothing wrong with splitting pieces of treatment between professions. PT's and OT's do it all the time. I am not always comfortable with it, knowing that I could be doing the spinal mobilizations myself, but the bigger picture is more important. We have a right to be adversarial to a profession (chiropractic) that has done harm to our profession and I don't begrudge anyone that emotion. I am just saying that you can look at it a different way and create something that helps the clients and helps the profession too. Tom Howell, P.T., M.P.T. Howell Physical Therapy Eagle, ID howellpt@... <mailto:howellpt%40fiberpipe.net> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 7, 2008 Report Share Posted February 7, 2008 With all due respect Mr. Ruchin, you have misinterpreted my wording. When I said, " just physical therapy " , I meant that some of our third party clients are referred for physical therapy and no other care (no chiropractic). In addition, I would like to respectfully point out that we do not just follow orders for these clients. We follow the same in depth evaluations that most do and create appropriate treatment plans just like we are taught. If a client does not need manual treatment, we educate them on our opinion and communicate with the chiropractor like we do with any professional involved in care. In most of these cases, our evaluation does show that the clients would benefit from our skills, no matter what that entails. It is no different from any other client that we evaluate. Our treatment is based on our evaluation and may include any or all of the skills we have available, including just exercise. As we are taught, the treatment should fit the findings. Working with chiropractors is a small piece of our business and I agree that there are risks involved with dual treatment; however, if you keep an open mind and drop the adversarial stance as we have, my point is that good things can happen. You get to know the practitioners, you get to educate them in what you do and you get a client who is educated on both professions and is in a better place to choose for themselves what care they feel is working best for them. I am happy to say a majority choose physical therapy! Tom Howell, P.T., M.P.T. Howell Physical Therapy Eagle, ID howellpt@... _____ From: PTManager [mailto:PTManager ] On Behalf Of Ruchin Sent: Thursday, February 07, 2008 4:57 AM To: PTManager Subject: RE: chiropractors " We also get referrals for just physical therapy so this model of referrals is one of many. " What is " just physical therapy " ? saying that does not help the profession at all. You are basically taking our manual skills away. Physical Therapy includes all types of treatment, INCLUDING manual. Manips when needed. Why are you settling for someone saying just PT. How do you know what therapeutic exercise to do if you do not have a feel for what is going on to their body. Are you just a personal trainer? BRYAN RUCHIN, PT, DPT Atlanta Rehabilitation and Performance Center 1735 Buford Highway, Ste. 310 Cumming, Ga. 30041 - Office - Fax bruchin@atlantareha <mailto:bruchin%40atlantarehab.com> b.com www.atlantarehab.com <http://www.atlantar <http://www.atlantarehab.com/> ehab.com/> chiropractors Hi everyone, Let me offer an additional perspective on chiropractors and dual treatment. Idaho is a full direct access state so we get referrals from many sources. One source is third party cases (ie auto accidents) through managing physicians who often refer clients to both a chiropractor and a physical therapist. The chiropractor most often does just spinal adjustments and the therapists then will do any soft tissue and exercises. This will vary depending on the chiropractor and the therapists involved. We also get referrals for just physical therapy so this model of referrals is one of many. Now before getting upset at this model, let me tell you that we have tried educating the managing physicians that this is an unnecessary waste of time but that has been unsuccessful. We could have refused business on principle but we looked at it another way. 1. We have the opportunity to treat clients that needed our help. 2. We have the opportunity to educate them on the differences between the professions and let them decide what worked best for them. 3. We have the opportunity to work with chiropractors in a positive way, coordinating care and addressing concerns in a way that educates them on what we do as well 4. We create relationships with chiropractors that develop into positive referral relationships as well 5. We create better understanding among the chiropractors of what we do. This came in handy in 2001 when we revised our practice act and were able to maintain the term " manipulation " in our practice act giving us full manual therapy abilities without restriction. In my opinion, there is nothing wrong with splitting pieces of treatment between professions. PT's and OT's do it all the time. I am not always comfortable with it, knowing that I could be doing the spinal mobilizations myself, but the bigger picture is more important. We have a right to be adversarial to a profession (chiropractic) that has done harm to our profession and I don't begrudge anyone that emotion. I am just saying that you can look at it a different way and create something that helps the clients and helps the profession too. Tom Howell, P.T., M.P.T. Howell Physical Therapy Eagle, ID howellptfiberpipe (DOT) <mailto:howellpt%40fiberpipe.net> net <mailto:howellpt%40fiberpipe.net> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 7, 2008 Report Share Posted February 7, 2008 In my 22 years in private practice my experience with chiro referral is: (1) The patient's insurance has totally been chewed up and there is nothing to gain monetarily. (2) Patients always tell me " " How come I did not come to you earlier? " (3) Case in point: Chiro sees this patient for 45 times for CT manip. Patient's workers comp ins tells her to go to PT, chiro sends the patient to me for evaluation only thinking that I will concur to his findings, I find that patient has a frozen shoulder, patient states: " I kept on telling the chiro that the pain is in my shoulder but he kept on cracking my neck " , I start tx for the patient's shoulder, patient's shoulder range improves, patient changes treatment to my clinic and is happy, patient receives a letter form chiro that it is a very grave mistake she is doing by not continuing her neck manip as the subluxed vertebrae is the culprit, patient brings the letter to me and is actually afraid that she may be making a mistake?, I laugh and standing in front of a tall mirror in my clinic I show her ROM of her shoulder improved with 8 visits in PT...make your decision, patient decides to stick to PT and is DC after 12 visits in PT with 90% of ROM and no pain with home exercise plan. (4) I wonder: Can this chiro actually sleep at night? (5) Lately in the last 3-4 years I have had no chiro referrals in my town ( maybe they talk to each other?!) Hiten Dave' PT chiropractors Hi everyone, Let me offer an additional perspective on chiropractors and dual treatment. Idaho is a full direct access state so we get referrals from many sources. One source is third party cases (ie auto accidents) through managing physicians who often refer clients to both a chiropractor and a physical therapist. The chiropractor most often does just spinal adjustments and the therapists then will do any soft tissue and exercises. This will vary depending on the chiropractor and the therapists involved. We also get referrals for just physical therapy so this model of referrals is one of many. Now before getting upset at this model, let me tell you that we have tried educating the managing physicians that this is an unnecessary waste of time but that has been unsuccessful. We could have refused business on principle but we looked at it another way. 1. We have the opportunity to treat clients that needed our help. 2. We have the opportunity to educate them on the differences between the professions and let them decide what worked best for them. 3. We have the opportunity to work with chiropractors in a positive way, coordinating care and addressing concerns in a way that educates them on what we do as well 4. We create relationships with chiropractors that develop into positive referral relationships as well 5. We create better understanding among the chiropractors of what we do. This came in handy in 2001 when we revised our practice act and were able to maintain the term " manipulation " in our practice act giving us full manual therapy abilities without restriction. In my opinion, there is nothing wrong with splitting pieces of treatment between professions. PT's and OT's do it all the time. I am not always comfortable with it, knowing that I could be doing the spinal mobilizations myself, but the bigger picture is more important. We have a right to be adversarial to a profession (chiropractic) that has done harm to our profession and I don't begrudge anyone that emotion. I am just saying that you can look at it a different way and create something that helps the clients and helps the profession too. Tom Howell, P.T., M.P.T. Howell Physical Therapy Eagle, ID howellptfiberpipe (DOT) <mailto:howellpt%-40fiberpipe.-net> net <mailto:howellpt%-40fiberpipe.-net> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 8, 2008 Report Share Posted February 8, 2008 Dave - Thanks for illustrating what I think is a central point: " What's wrong with the patient? " There is a big difference between, say, " Subluxed C3 " and " Adhesive capsulitis " . It appears to me that in diagnosis (an activity which *is* within the scope of PT) rather than which techniques we each may use, is where there may be substantive differences. Without a good diagnosis, all else may be wasted. Dick Hillyer, DPT Dr. W. Hillyer Lee Therapist Group, LLC Hillyer Consulting Cape Coral, FL 33914 _____ From: PTManager [mailto:PTManager ] On Behalf Of Hiten Dave Sent: Friday, February 08, 2008 12:59 AM To: PTManager Subject: RE: chiropractors In my 22 years in private practice my experience with chiro referral is: (1) The patient's insurance has totally been chewed up and there is nothing to gain monetarily. (2) Patients always tell me " " How come I did not come to you earlier? " (3) Case in point: Chiro sees this patient for 45 times for CT manip. Patient's workers comp ins tells her to go to PT, chiro sends the patient to me for evaluation only thinking that I will concur to his findings, I find that patient has a frozen shoulder, patient states: " I kept on telling the chiro that the pain is in my shoulder but he kept on cracking my neck " , I start tx for the patient's shoulder, patient's shoulder range improves, patient changes treatment to my clinic and is happy, patient receives a letter form chiro that it is a very grave mistake she is doing by not continuing her neck manip as the subluxed vertebrae is the culprit, patient brings the letter to me and is actually afraid that she may be making a mistake?, I laugh and standing in front of a tall mirror in my clinic I show her ROM of her shoulder improved with 8 visits in PT...make your decision, patient decides to stick to PT and is DC after 12 visits in PT with 90% of ROM and no pain with home exercise plan. (4) I wonder: Can this chiro actually sleep at night? (5) Lately in the last 3-4 years I have had no chiro referrals in my town ( maybe they talk to each other?!) Hiten Dave' PT chiropractors Hi everyone, Let me offer an additional perspective on chiropractors and dual treatment. Idaho is a full direct access state so we get referrals from many sources. One source is third party cases (ie auto accidents) through managing physicians who often refer clients to both a chiropractor and a physical therapist. The chiropractor most often does just spinal adjustments and the therapists then will do any soft tissue and exercises. This will vary depending on the chiropractor and the therapists involved. We also get referrals for just physical therapy so this model of referrals is one of many. Now before getting upset at this model, let me tell you that we have tried educating the managing physicians that this is an unnecessary waste of time but that has been unsuccessful. We could have refused business on principle but we looked at it another way. 1. We have the opportunity to treat clients that needed our help. 2. We have the opportunity to educate them on the differences between the professions and let them decide what worked best for them. 3. We have the opportunity to work with chiropractors in a positive way, coordinating care and addressing concerns in a way that educates them on what we do as well 4. We create relationships with chiropractors that develop into positive referral relationships as well 5. We create better understanding among the chiropractors of what we do. This came in handy in 2001 when we revised our practice act and were able to maintain the term " manipulation " in our practice act giving us full manual therapy abilities without restriction. In my opinion, there is nothing wrong with splitting pieces of treatment between professions. PT's and OT's do it all the time. I am not always comfortable with it, knowing that I could be doing the spinal mobilizations myself, but the bigger picture is more important. We have a right to be adversarial to a profession (chiropractic) that has done harm to our profession and I don't begrudge anyone that emotion. I am just saying that you can look at it a different way and create something that helps the clients and helps the profession too. Tom Howell, P.T., M.P.T. Howell Physical Therapy Eagle, ID howellptfiberpipe (DOT) <mailto:howellpt%-40fiberpipe.-net> net <mailto:howellpt%-40fiberpipe.-net> Quote Link to comment Share on other sites More sharing options...
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