Guest guest Posted February 8, 2008 Report Share Posted February 8, 2008 Mr. Howell, If you are doing what you say you are doing, how can co-treating be beneficial unless you are performing the same manual treatments as the chiro. Would your manual treatments, if deemed necessary based on your evaluation, be different than the chiro. Maybe I am having a hard time seeing your meaning. I can understanding developing relationships within the medical community and from one practitioner to another, but tell me this, what other profession co-treats using the same theory and types of treatment? Dr. Ruchin 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 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 Hi everyone, As I said in my earlier posts, I understand the passion and emotions that PT's have regarding chiropractors and I don't begrudge you them. I accept that you disagree with our philosophy. I do feel like I have to explain our philosophy a bit farther. While I do not agree with in depth chiropractic philosophy, I do agree that manipulation of the spine is an appropriate and research based approach in many of the third party cases I was referring to earlier where chiropractic is involved. If my evaluation shows that manipulation of the spine is not appropriate, I educate my patient/client on my findings. Ultimately it is up to the informed patient/client to decide. I do not double up on spinal manipulation if the patient/client is receiving manipulation from the chiropractor. Instead I focus on other areas of physical therapy that may help, based on the evaluation. (exercise, soft tissue work, education, back school, ergonomics etc) The treatment is then coordinated with the chiropractor. If the patient/client is educated about their treatment (which we always do), about the differences between chiropractic and physical therapy (which we always do) and then still feels they are being helped by the chiropractor, who am I to stop them? Our first priority is to the patient/client not to our own biases. All we can do is educate and give the patient/client the tools to make an informed decision. The fact is many clients will continue with both chiropractic and physical therapy. Whether I like it or not is irrelevant. Instead we have looked past the negatives and made it a positive thing by coordinating care, educating patient/clients and chiropractors and focusing on what we can do to promote recovery within the system we are given. Look I know that you may still disagree and I will not continue to belabor this. I appreciate that you may think this is wrong. We do not. If anything, I hope that I have made you think a bit on this Friday on February! With all respect, Tom Howell, P.T., M.P.T. Howell Physical Therapy Eagle, ID howellpt@... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 11, 2008 Report Share Posted February 11, 2008 , I have co-treated multiple times with a chiropractor, as I rent space out of a chiro clinic.....interesting, I know. When I read two seperate postings stating not to treat simultaneously with PT, my question is, why not? I am an orthopedic PT and I do not perform manipulations. If chiro can assist with some pain relief when I cannot, why not? My patients thank me over and over for the insight of suggesting a chiro. These patients have usually used chiro in the past and are open to the idea. I continue with exercise and modalities as needed. Works for me, and also for some of my patients. Maybe seeing how two different professions can work together can be of benefit to a patient after all. Matt Dvorak, PT Yankton, SD ________________________________ From: PTManager on behalf of keith bisesi Sent: Tue 2/5/2008 9:18 PM To: PTManager Subject: RE: chiropractors 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 <ericschweitzer2@... <mailto:ericschweitzer2%40yahoo.com> > 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 <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 > === message truncated === __________________________________________________________ Never miss a thing. Make Yahoo your home page. http://www.yahoo.com/r/hs <http://www.yahoo.com/r/hs> Quote Link to comment Share on other sites More sharing options...
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