Friday, September 15, 2006

THE CHIROPRACTIC DEBATE

Apparently, I pissed off some chiropractor with my previous entry on chiropractic medicine. I wanted to post his message and my response here so that people could send in their thoughts on the issue.

Chiropractic Comment:
To each in their own opinion, however i thought it might be helpful in your condemnation of chiropractic schools to get the facts correct. A chiropractic student must complete a 5 year program at an accredited college. They must take the board exams which consist of 4 parts taken over a period of 3 years, the last part of which is an oral/practical exam. Students take 270 hours of Radiology (as opposed to the medical counterpart who recieves 30 hours of training). To round it off, chiropractic students take 585 hours of Anatomy, 75 hours of Biochemistry, 345 hours of Physiopathology, 120 hours of microbiology, 525 hours of Diagnosis, 75 hours of Clinical Lab Diagnosis, 1,320 hours of Internship.... and many more not worth mentioning. No, Chiropractors cannot treat pathological problems, but they are taught to recognize them so when the patient comes in complaining of back pain the DC can differentially diagnose if it is or is not an emergency which should be referred out. I would advise not stereotyping a profession in which you obviously have the facts incorrect. Im sure you would agree that there are many MD's out there riding that subtitle for unethical reasons. Dont forget that healthcare is for the patient, and the best thing for the patient is for all health professions to work together.

My response:
Points well taken. I fully agree with thoughts on unethical MDs, and the team work approach to healthcare. However, your facts, just as mine, are a bit off. I will address only one here simply for the sake of time and because right now, I don't care.

Concerning your quote on radiology hours in training. It seems to me that an extremely large part of your practice as a chiropractor involves the use of xrays. So, in your 5 years of training, you undergo 270 hours of radiology. Then, you are practicing in the community reading thousands of xrays yearly as a fully functioning chiropractor - with no professional radiologist over reading these xrays looking for things you've missed. Basically, chiropractic care, at least in the realm of radiology, has no quality control.

Here's the big difference. You were wrong on the idea that MDs only get 30 hours of radiology. To make it simple (like finding a pulmonary nodule on a portable chest xray), I'll break it down for you. Med students go through 4 years of med school, in which they see xrays throughout, but much more their 3rd and 4th years. All typically take a rotation in radiology during their 4th year where they sit with practicing "radiologists" (those who are professionals in radiology) and learn the basics of how to read the different modalities of imaging, xrays or other. Now the good part, after med school, MDs have to do a residency! That's another 3 to 5 to 10 years depending on how crazy they are. No matter what field or subspecialty they go into, they will be reading xrays, CT, and maybe an MRI or two the entire time on all their patients. Plus these are over read by professional radiologists so that things aren't missed. Medical doctors have a quality control system in place.

So the breakdown stands as such,

Chiropractors:
Practice nearly revolves around the use of xrays and they get 270 hours of radiology. Then they're reading them on their own - without radiologist over read.

MDs:
Little formal radiology training, but spend nearly 4-8 years reading xrays every day and having them over read by professionals before they are out in the community. Plus, once out in the community, the xrays are still read by a radiologist.

You do the math.

3 Comments:

Anonymous john said...

I agree with you. I am a chiropractor and have all of my x-ray read by a board certified chiropractic radiologist. These doctors are every bit as good as the M.D. radiologist..." I think because of a chip on the old shoulder " About 2-3 times a year they find something that I have missed that is really important to follow up on. I have used a chiropractic radiologist for 10 years.

P.S. Chiropractic is a really great profession and I can't think of anything I would rather do..... well maybe pro golfer... he he he

Dr. J

9:53 PM  
Blogger Criminallopath said...

Any word yet on that definative double blind study showing (1) high interobserver agreement regarding the presence of "vertebral subluxation complexes" and (2) the lack of pressence of the same in the asymptomatic and heatlhy population?

2:23 AM  
Blogger Caduceus said...

No

11:32 PM  

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