other health professions DPM/OD/DO, etc.

[sprog]

If you want to believe that I'm some kook who somehow ginned up a bunch of websites about the scam of chiropractic "medicine" that's fine. I only wish I had those sorts of organizational skills.

Your inflamed response didn't address a few issues...

1. The dangers of arterial dissection in chiropractic care

2. The low admissions standards of chiropractic colleges.

3. Why so many qualified folks (other than the one you were already primed to debunk) from the US, Canada, and the UK are opposed to
Chiropractors and their trade

4. The fact that chiropractics is designed to generate lifelong patient dependency through regular manipulations

5. Why, if it's real science and medicine with real standards, is it only taught at tiny chiro colleges? You can go to a major university and become a DO, DDS, or PT. But the only place you can learn the concept of "subluxation" is at a tiny, virtually unknown school. Why is that?

I'm going to start out by saying that I'm no expert on this....

My impression on this debate is that chiropractic success is something that has only been attested to in an anecdotal fashion. This is, essentially, the problem that the AMA has always had with it. Throughout most of history, medicine and all of its derivatives were not scientific. In the last century that changed with regard to allopathic medicine (and also osteopathic medicine). Chiropractic care is in a different category, and hence the feeling of hostility to it.

Nonetheless, I do believe there has been a recent feeling in the allopathic/osteopathic community that there can be a benefit in treating lumbosacral spine issues (DOs are even trained to some degree in spinal manipulation, although most of them don't use it). Things like chronic low back pain and lumbar strain have been observed to respond to chiropractic care (even if as just a narcotic-free palliative). If the care is limited to that type of treatment, and there are no unverified claims of spinal manipulation being able to treat cancer, heart disease, etc., then the medical community (or at least parts of it) is warming to chiropractors.

Like scout, I have heard bad things about cervical spine chiropractic adjustments. I'm under the impression that physicians will not refer to a chiropractor for neck issues because of the arterial dissection concerns.

If I have low back pain that is unresponsive to other treatment, I might consider chiropractic care if it is suggested by my doctor. I would look for a chiropractor who didn't make outrageous claims and who was focused on making my back better. Even if it isn't much more than a massage, if it helps, I can see the value in that limited scope.

 

[scoutpilot]

I'm going to start out by saying that I'm no expert on this....

My impression on this debate is that chiropractic success is something that has only been attested to in an anecdotal fashion. This is, essentially, the problem that the AMA has always had with it. Throughout most of history, medicine and all of its derivatives were not scientific. In the last century that changed with regard to allopathic medicine (and also osteopathic medicine). Chiropractic care is in a different category, and hence the feeling of hostility to it.

Nonetheless, I do believe there has been a recent feeling in the allopathic/osteopathic community that there can be a benefit in treating lumbosacral spine issues (DOs are even trained to some degree in spinal manipulation, although most of them don't use it). Things like chronic low back pain and lumbar strain have been observed to respond to chiropractic care (even if as just a narcotic-free palliative). If the care is limited to that type of treatment, and there are no unverified claims of spinal manipulation being able to treat cancer, heart disease, etc., then the medical community (or at least parts of it) is warming to chiropractors.

Like scout, I have heard bad things about cervical spine chiropractic adjustments. I'm under the impression that physicians will not refer to a chiropractor for neck issues because of the arterial dissection concerns.

If I have low back pain that is unresponsive to other treatment, I might consider chiropractic care if it is suggested by my doctor. I would look for a chiropractor who didn't make outrageous claims and who was focused on making my back better. Even if it isn't much more than a massage, if it helps, I can see the value in that limited scope.

Good points all.

For the record, it's not just me saying this about the dangers:

http://www.medscape.com/viewarticle/726445

From International Journal of Clinical Practice
Deaths after Chiropractic: A Review of Published Cases
E. Ernst
Authors and Disclosures
Posted: 08/30/2010; Int J Clin Pract.*2010;64(10):1162-1165.*©*2010*Blackwell Publishing
Abstract and Introduction

Abstract

Objective: The aim of this study was to summarise all cases in which chiropractic spinal manipulation was followed by death.
Design: This study is a systematic review of case reports.
Methods: Literature searches in four electronic databases with no restrictions of time or language.
Main outcome measure: Death.
Results: Twenty six fatalities were published in the medical literature and many more might have remained unpublished. The alleged pathology usually was a vascular accident involving the dissection of a vertebral artery.
Conclusion: Numerous deaths have occurred after chiropractic manipulations. The risks of this treatment by far outweigh its benefit.

Introduction

Vascular accidents after upper spinal manipulation are a well-recognised problem (e.g.[1,2]). Dissection of a vertebral artery, caused by extension and rotation of the neck beyond the physiological range of motion, is thought to be the underlying mechanism.[2] Several deaths have been reported as a consequence. Some proponents of chiropractic seem to believe that the critical evaluation of this evidence amounts to a 'scare story' (Chairman of the UK General Chiropractic Council)[3] or to 'puffing up (the evidence) out of all proportion' (President of the British Chiropractic Association).[4] A responsible approach to serious therapeutic risks, however, requires an open discussion of the facts.

In this review, I aimed to provide the basis for such a discussion by summarising all fatalities which occurred after chiropractic spinal manipulation and were published in the medical literature.

References***|***Sidebar

 

[Pima]

Scout,

Just out of curiosity, but from a current flier would your flight doc refer you to visit a chiropractor?

I am thinking No. The pure reason why is what you have stated, there could be more damage if done incorrectly.

For me, as a parent of a child that will be commissioned as an AF O1 in May, and a spouse of a flier, I have to say that was always my baseline in my decision making process regarding medical issues.

If the AF said they would not allow Bullet to have this done to his body, I wanted more info before they did it to me or our children.

I am not dogging this industry, I am saying that from a flier's perspective they have the highest level, IMPO, from a medical perspective.

No exaggeration, when DS was diagnosed with a maybe heart murmur at 4 yo, I turned to the Flight Doc and asked if he could be in the AF. The doc pulled out the book, and said yes. He asked why I asked, and I said as a Mom, if the AF said yes, than I knew I had nothing to worry about.

IMPO, if the military does not allow fliers to go to a chiropractor, that tells me that this is not an acceptable treatment for everyone. That means there are more risks than rewards according to them.

I agree with scout on this issue. I don't think he is slamming the industry, he is stating from his perspective, that in his world this is a no-go. Fliers are very aware of medical issues. These people will not use Afrin nasal spray. They have a higher DoDMERB bar than the officer that works at Acct & Fin. If the A &F officer can get chiro services, and they can't you must question why? The answer is what scout stated.

Lastly chiro,

Your defense about the med was misguided when it comes to scout. His DW is a doc. If any flier, AD member on this site has true insight, I have to say it is him!

 

[scoutpilot]

Scout,

Just out of curiosity, but from a current flier would your flight doc refer you to visit a chiropractor?

I am thinking No. The pure reason why is what you have stated, there could be more damage if done incorrectly.

For me, as a parent of a child that will be commissioned as an AF O1 in May, and a spouse of a flier, I have to say that was always my baseline in my decision making process regarding medical issues.

If the AF said they would not allow Bullet to have this done to his body, I wanted more info before they did it to me or our children.

I am not dogging this industry, I am saying that from a flier's perspective they have the highest level, IMPO, from a medical perspective.

No exaggeration, when DS was diagnosed with a maybe heart murmur at 4 yo, I turned to the Flight Doc and asked if he could be in the AF. The doc pulled out the book, and said yes. He asked why I asked, and I said as a Mom, if the AF said yes, than I knew I had nothing to worry about.

IMPO, if the military does not allow fliers to go to a chiropractor, that tells me that this is not an acceptable treatment for everyone. That means there are more risks than rewards according to them.

I agree with scout on this issue. I don't think he is slamming the industry, he is stating from his perspective, that in his world this is a no-go. Fliers are very aware of medical issues. These people will not use Afrin nasal spray. They have a higher DoDMERB bar than the officer that works at Acct & Fin. If the A &F officer can get chiro services, and they can't you must question why? The answer is what scout stated.

Lastly chiro,

Your defense about the med was misguided when it comes to scout. His DW is a doc. If any flier, AD member on this site has true insight, I have to say it is him!

No military flight surgeon I know of would ever refer a flier to a chiropractor. I do not know what the regs say.

If the military saw true value in chiropractors, they'd have them in the ranks. We have DOs and PTs, but no Chiros. Hmmmm...

 

[Pima]

Thanks scout.

I thought that would be the answer, but since Bullet retired in 08, I wanted to make sure things did not change over yrs.

chiro,

For any military branch their biggest investment regarding personnel, will be fliers.

They are called the Million Dollar Man/Woman because it costs millions to train them to be fliers. How much does it cost them to train an SP officer? MI?

If their back goes out, does it impact their ability to complete the mission compared to a flier?

You may believe they are naive, ignorant or arrogant not to acknowledge the benefits of your field.

If they are, it is because the military when it comes to their "golden child" will not allow this as a prescription for their ailment.

Scout as I stated earlier was not being disrespectful or rude, nor ignorant. He was stating the true hard facts from an AD flier's position.

JMPO, I think you have tunnel vision in this issue, and scout was trying to increase your peripheral view regarding the AD world.

 

[Aglahad]

No military flight surgeon I know of would ever refer a flier to a chiropractor. I do not know what the regs say.

If the military saw true value in chiropractors, they'd have them in the ranks. We have DOs and PTs, but no Chiros. Hmmmm...

Well DOs are literally the same thing as MDs with the osteopathic training that I rarely seem implemented. If anything perhaps DOs have a more holistic outlook on medicine (as well as lower barriers to entry than allopathic schools). PTs have an entirely different focus (systemic rehab vs musculoskeletal manipulation) than chiropractors and rather than join manipulation can branch into a wide array of specialties and plans of care.

If you are going to point out the dangers of chiropractors and tunica arterial dissection you would have to also acknowledge the dangers of stepping into one of the US's hospitals. Rates of error and infection from medical and nursing care is sky high and all too often deadly. There are many cases of people coming into the hospital with very minor issues and leaving after a bout of necrotizing fasciitis or HAP. That is just sloppy infection control and not even getting into errors in assessments, diagnosis, meds or procedures. Even verified science can go wrong in certain cases.

All I am saying is not to discount what they do as superstitious magic or a crock spin off of medicine. It is up to the individual to discern if a chiropractor is right for them and the DoD does still refer through TRICARE on post.

 

[scoutpilot]

Well DOs are literally the same thing as MDs with the osteopathic training that I rarely seem implemented. If anything perhaps DOs have a more holistic outlook on medicine (as well as lower barriers to entry than allopathic schools). PTs have an entirely different focus (systemic rehab vs musculoskeletal manipulation) than chiropractors and rather than join manipulation can branch into a wide array of specialties and plans of care.

If you are going to point out the dangers of chiropractors and tunica arterial dissection you would have to also acknowledge the dangers of stepping into one of the US's hospitals. Rates of error and infection from medical and nursing care is sky high and all too often deadly. There are many cases of people coming into the hospital with very minor issues and leaving after a bout of necrotizing fasciitis or HAP. That is just sloppy infection control and not even getting into errors in assessments, diagnosis, meds or procedures. Even verified science can go wrong in certain cases.

All I am saying is not to discount what they do as superstitious magic or a crock spin off of medicine. It is up to the individual to discern if a chiropractor is right for them and the DoD does still refer through TRICARE on post.

They will refer DEPENDENTS. Big difference. Our flight surgeons will flat out tell you "no" as an AD patient.

I know you've done clinical work, but you're just dipping your toes into the AMEDD world as a cadet/nursing student.

You're right, we do have DOs (as sprog mentioned). The fact that DOs, who are trained in real scientific medicine and chiropractic-type "manipulations," by and large eschew the manipulations tells us something.

Yes, there is risk in stepping into a hospital. There is risk in stepping into a hospital. There is risk in all medical care. The difference being that true, scientific medical care is based on verifiable science and research, which is why the known and reproducible benefits outweigh the risks.

 

[LineInTheSand]

They are called the Million Dollar Man/Woman because it costs millions to train them to be fliers.

I was under the impression they were called that because of how much they spend on hair products.

 

[shoots1994]

I have a slightly off-topic question:

I want to be an orthopedic surgeon. I understand that going to the AFA, then med school, then residency, then perhaps a fellowship, will obligate me to serve a minimum of 13 years in the AF. This is my dream, and I have no problems with the time commitment. However, after my military career comes to an end, will I be at a disadvantage, as compared to my peers who have been working in hospitals much longer than I would have (I think)? Will I be able to establish a practice as well and as quickly as them? Or will I have to work a couple extra years to get more experience?

Also, I've read that promotions in the AF are given based on qualifications and years served--what rank do orthopedic surgeons (or any specialized practitioner, really) achieve once they get out of their residencies/fellowships/whatever? Do they start at O-1? Or something higher?

 

[goaliedad]

I have a slightly off-topic question:

I want to be an orthopedic surgeon. I understand that going to the AFA, then med school, then residency, then perhaps a fellowship, will obligate me to serve a minimum of 13 years in the AF. This is my dream, and I have no problems with the time commitment. However, after my military career comes to an end, will I be at a disadvantage, as compared to my peers who have been working in hospitals much longer than I would have (I think)? Will I be able to establish a practice as well and as quickly as them? Or will I have to work a couple extra years to get more experience?

Also, I've read that promotions in the AF are given based on qualifications and years served--what rank do orthopedic surgeons (or any specialized practitioner, really) achieve once they get out of their residencies/fellowships/whatever? Do they start at O-1? Or something higher?

If you are lucky enough to have the military pay for your medical school (the luck part is getting into the program), you will come out with a big advantage of a couple hundred thousand in debt you won't be making payments on like your private sector peers.

There are others here who have been through the process and can speak of the transition to private practice, but everythin I've heard is that the military surgeons get experience as good as or better than those outside because of the patients they work on.

 

[Aglahad]

They will refer DEPENDENTS. Big difference. Our flight surgeons will flat out tell you "no" as an AD patient.

I know you've done clinical work, but you're just dipping your toes into the AMEDD world as a cadet/nursing student.

You're right, we do have DOs (as sprog mentioned). The fact that DOs, who are trained in real scientific medicine and chiropractic-type "manipulations," by and large eschew the manipulations tells us something.

Yes, there is risk in stepping into a hospital. There is risk in stepping into a hospital. There is risk in all medical care. The difference being that true, scientific medical care is based on verifiable science and research, which is why the known and reproducible benefits outweigh the risks.

Fair enough. I did not know they wouldn't refer AD. I understand the risk vs benefit ratio I just wanted others to know that standard medicine even grounded in verifiable science can make horrendous blunders as does chiropractic care. I do get your overarching point regarding the fact that medicine gets results in almost cases. However, chiropractors can be used in other facets such as palliative care where other than benzos and opioids medicine can't help.

I am finishing my pre-med reqs for DO school and will most likely take the MCAT while an RN on AD so the issue of joint manipulation/osteopathic medicine is of particular interest to me (reason for me commenting).

You're right about my limited army/AMEDD experience, but it does help that my clinicals are done at an army MEDECEN so I have the chance to talk as well as work with docs of all spectrums everyday, weigh their opinions and cultivate my experiences.

 

[Aglahad]

I have a slightly off-topic question:

I want to be an orthopedic surgeon. I understand that going to the AFA, then med school, then residency, then perhaps a fellowship, will obligate me to serve a minimum of 13 years in the AF. This is my dream, and I have no problems with the time commitment. However, after my military career comes to an end, will I be at a disadvantage, as compared to my peers who have been working in hospitals much longer than I would have (I think)? Will I be able to establish a practice as well and as quickly as them? Or will I have to work a couple extra years to get more experience?

Also, I've read that promotions in the AF are given based on qualifications and years served--what rank do orthopedic surgeons (or any specialized practitioner, really) achieve once they get out of their residencies/fellowships/whatever? Do they start at O-1? Or something higher?

No, you will have a great advantage over most of your peers both education and experience wise.Military medicine is top notch with their various schools and programs such as structured residencies, HPSP and USUHS. Military hospitals (especially Bethesda/WR) are state of the art facilities and often way ahead of their civilian counterparts in terms of successful patient outcomes.

Physicians come out of med school as O-3s in most cases.

May I suggest forums.studentdoctor.net if you are looking for info on the DO/MD route. They have a military sub forum that is heavily trafficked by AD docs of every branch.

In the mean time focus on the here and now, the pre reqs. I can attest to the difficulty of the bio, physics, and o-chem. Make the grades and study hard for the MCAT before you think too far ahead. A lot of freshman come to college hoping to be docs but most drop pre-med after one bio or chem class and switch majors. Stay focused and keep your science gpa 3.4 or better.

 

[shoots1994]

Thanks Aglahad and goaliedad! Your posts really help.

Aglahad: Can I ask what you're majoring in? What kind of med school will you be applying to? I'm still a little confused as to how you can go to med school directly after college. Do you have to go to the USUHS or can you go to any civlian college with an HPSP scholarship?

Also, HOW DO YOU FIND TIME TO STUDY FOR THE MCATS???? I understand you're AROTC and others at SA's will have the same problem of not having enough time etc etc. Did you start studying in your freshman year or what? Did you take those MCAT prep classes some universities offer in the summer?

 

[Aglahad]

Thanks Aglahad and goaliedad! Your posts really help.

Aglahad: Can I ask what you're majoring in? What kind of med school will you be applying to? I'm still a little confused as to how you can go to med school directly after college. Do you have to go to the USUHS or can you go to any civlian college with an HPSP scholarship?

Also, HOW DO YOU FIND TIME TO STUDY FOR THE MCATS???? I understand you're AROTC and others at SA's will have the same problem of not having enough time etc etc. Did you start studying in your freshman year or what? Did you take those MCAT prep classes some universities offer in the summer?

BS in Nursing is my major right now and I am a senior. I am mainly applying to DO schools because they value past medical experience more so than MD schools (although I am applying to MD as well) and I am interested in osteopathic medicine. You can go to med school right after college but my health sciences counselor says that schools are increasingly looking for older well rounded applicants with life experience. He went as far to say that 30 was the optimal age for applying. Granted this is just his opinion but an experienced 30 y/o who was a prior paramedic, PA, PT, RN will undoubtedly have a leg up on some 22 y/o inexperienced kid right out of undergrad.

I believe you can do either with the HPSP scholarship or attend USUHS.

I study for the MCAT here and there. I look at flash cards and review from time to time after I take each pre med course. Since I am still a nursing major I spend most of my time study med-surg and gearing up for my NCLEX boards, pharm and interventions. Clinicals take up a huge amount of time and the majority of my efforts for med school (MCAT, finishing pre reqs etc) will be while I am on AD as a RN. For traditional students you usually take the MCAT sometime during or right after your junior year.

I hear most people say prep classes are for those not motivated enough to study on their own. Essentially all they entail are proctored practice tests over and over. You can do the same thing yourself if you sit down with a study book an dedicate yourself to the material.

If have more questions just pm me

 

[hornetguy]

Also, HOW DO YOU FIND TIME TO STUDY FOR THE MCATS???? I understand you're AROTC and others at SA's will have the same problem of not having enough time etc etc. Did you start studying in your freshman year or what? Did you take those MCAT prep classes some universities offer in the summer?

If it is a priority for the person, there is time to study. Personally, I read the biology MCAT study book from the USAFA library and then took the test. No other studying (my chemistry major was good prep in itself as well as the science core at USAFA). Did very well on the test. I think paying attention and doing well in your chemistry, biology, and physics courses is better preparation than an MCAT study course....

 

[kp2001]

So I've been meaning to post in this thread for a few days and I'll try to remember everything I wanted to say.

Referring pilots/aircrew to chiropractors: Sure, I've done it and would do it again for the right patient for the right condition. One of the problems is that it has to be a chiropractor at a military treatment facility (either my facility wouldn't pay or it's not Tricare covered for AD, I can't remember) so I was limited. It was much easier to refer them to my partner who was a D.O. who loved doing manipulations.

Shoots1994: Your commitment would be 20+ years long if you took the route you currently propose. Not the 13 you state. (5 for AFA, 4-7 for med school, and then five for ortho residency plus 1yr for each yr of fellowship of which none of these start until you are out of training)

Will you need more training when you go civilian? No, you would be hard pressed to set up your own practice, but would do just fine joining a practice/hospital/academia.

BTW: What does "more holistic approach" even mean? This is such a pile of bull that is talked about by DO's, NP's, etc etc. (Don't worry, you don't really have to answer this, just a pet peeve of mine when people say this baloney)

Aglahad: the military residencies are usually considered middle of the road in their 'prestige.' This used to not be the case; however, due to many decisions over the last 20 years the military has lost some of the prior prestige it had among its residencies. The closing of AFIP was one of the latest hits. Patient outcomes are very important, but they don't make a training program. When your patient population is way healthier than the general population it is tough to compare yourself. The exception would be the care of our wounded warriors. During wartime military medicine makes some incredible advances, give us five to ten years of peace and we will have to reinvent the wheel because pretty much everyone who went through the experience will have retired or moved on. This is one of the problems with mil med: those with the most experience are forced out either through a severe lack of pay or by hitting the retirement window (or they don't want to deal with moving again, etc etc).

Your counselor is not entirely correct. Yes, med schools seem to be giving a look to nontraditional grads; however, that applicant really has to shine in comparison to a recent college grad with a good application. Medical training is a young person's game. Those of us who may be a bit older bring some diversity, but also can have different priorities beyond wanting to work 80+ hrs a week.

 

[scoutpilot]

I love kp2001's posts!

BTW: What does "more holistic approach" even mean? This is such a pile of bull that is talked about by DO's, NP's, etc etc. (Don't worry, you don't really have to answer this, just a pet peeve of mine when people say this baloney)

It's one of my favorite DO claims!

 

[LOVEARMY]

MED School

1. I Agree with everything Scout Pilot says. I am married to an military physician and he is an DO.

2. Go to civilian medical school, pay for it yourself. Do not buy into the fact the military will pay for it. You will make far more money outside then inside the military. You will never make the same amount of money in the military as outside. If you do have the military pay for your med school get out the first chance you can. Control your destiny. Take care of yourself and your family. Make sure you fully understand what you are getting your self into. Talk to military docs every chance you can.