“Why Chiropractic and Not PT?”

This is a question that comes up often in my conversations with other DCs and with MDs that I work with.  What makes chiropractic different from PT?  The MDs feel, believe it or not, that they have more control over what happens in physical therapy.  They feel they are protecting their licenses and patients by “supervising” care.  The MDs that send patients to a “specialist” (ortho, neuro, pain management), are also protecting their licenses because that is a legally defensible referral should anything happen.

Did you know it wasn’t until 1986 that the AMA officially retracted the notion that it was unethical for MDs to work with chiropractors?  I would venture to guess that many of the MDs that you know may have been in medical school or private practice before 1986.  That is one part of the problem.  Since they were out of school, the AMA has changed their stance on chiropractic, but while they were in school what type of information do you think they were getting?  Right, they were getting wrong information, so what do we do?

Chiropractic care is DIFFERENT than the care provided by any other profession and the education starts with you.  You need to be the leader and beat the chiropractic drum, softly at first…If the MD sees you as another “therapist,” then they he/she will send his/her patients to the PT which is what he/she has always done.  Remember, MDs don’t get a referral handbook in medical school and have very little training in how or who to refer to.  The orthopedic surgeon that I work with on a daily basis even said when I asked him, “We were never instructed to send to PT.”  That is a very interesting point. If the MDs were not trained to send to PT, why do they?  They do it to cover their…Well, you know what I mean.  It is based on rhetoric that they obtained ONCE THEY GRADUATED.  It’s not the medical schools, it’s the real world that is disseminating this incorrect information. 

Let’s fix it and get thousands of new patients into your office.  Like I have said in multiple consultations, it starts with YOU, not CHIROPRACTIC.  The MD has to trust that you are the real deal and are clinically proficient.  The days of “I am a healer,” or “I am a chiropractor; that is what I do,” are over, like it or not.  We are all of those things and it is a blessing and a burden at times, but the reality is you are a DOCTOR.  Doctors are able to reason through complex clinical problems.  Physical therapists are THERAPISTS.  They take direction from the MDs.  That is not what you tell the MDs.  I work with PTs all the time.  They are very good at what they do, but you have a unique opportunity to stand out from the crowd and make a difference.  That is where your CV and your doctoring come into play.   How you interact with the MD says it all.  You must see yourself as a peer which means don’t pander for patients, but don’t take any crap either.   I found that when I encounter a less than cooperative MD (typical demographic would be 55-70 years old and disillusioned with private practice), I say to myself, “Bite me.”  That always makes me smile and allows me to deflect the negative energy.  Remember, the purpose of the program is to find the MDs that want to cooperate for the benefit of their patients and to NOT get bogged down by the .5% that are idiots. 

In the end, it is about YOU, the DOCTOR, first.  Be a doctor that cares and have the credentials to back up your opinions and words.  Otherwise, it’s all BS.  You do that and MDs will understand why a conservative spine specialist is the place to start and will chose chiropractic over PT.

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