"Every patient carries her or his own doctor inside."
                              Albert Schweitzer   1875 1965

"If you trust Google more than your doctor then maybe it's time to switch doctors"

   Jadeir and Cristina Cordova
CHIROPRACTIC TODAY      

CHIROPRACTIC HEALTH PATIENT


Health Patient (HP) has a broad definition in our office.  These patients have established a history with us of electing to utilize and/or purchasing health equipment, receive advice and/or education, and/or supplementaton.  They vary greatly in their frequency of adjustments (CMT and/or CPT).  Some have specific goals and others more generalized.  They participate in our state's broader scope of practice;  they are viewed as more receptive to natural health and alternative practices, to varied degrees.  We view them all as our chiropractic patients.  Please review our "Informed Consent" form.  These patients may be asked to sign waivers to recognize any reasonable limitations and expectations.
"Chiropractic Physiological Therapeutics includes, but is not limited to, modalities which produce electrical current, light, air, water, thermal (hot or cold), percussion, vibration, traction, sonic wave; colonic irrigaton and rehabilation equipment (bracing and casting)."  State of Alabama

"Chiropractic is the science and art of locating and removing without the use of surgery and drugs any interference with the transmission and expression of nerve energy in the human body by any reason or method taught in schools or colleges of chiropractic.....examine and analyze, and diagnose the human body and its diseases by the use of any physical, clinical, thermal, or radonic method and the use x-ray diagnosing and  and analysis...other general methods of examination for diagnosis and analysis....... recommend the use of foods, concentrates, food extracts, and apply first aid and hygiene..."

             State of Alabama,  Code of Alabama 1975
                            Title 34, Ch. 24, Art. 4, Div. 1
FEDERAL COURT ACTION AGAINST AMA 1987

In a second court trial in Federal court, the AMA was found in violation of Section 1 of the Sherman Act stating irrefutable evidence showing an "unlawful conspiracy in restraint of trade".  Further it was stated that the AMA tried "to contain and eliminate the Chiropractic profession."  The judge added that a long history of illegal behavior had existed in this intent.  The AMA is under Federal court injunction under the Clayton Act. The AMA has lost in all efforts to appeal this decision.  Dr, Chester Wilks and several chiropractors spent much time and resources on behalf of chiropractors.  The easiest way to review the facts of this case is to review Wikipedia under "Wilks vs. American Medical Association."

INFORMATION ESSAY ON INCOME OF HEALTH PROVIDERS


Many things go ignored when considering average incomes with doctors.  Areas often determine costs of services in any country or in any local region.  Medical incomes are more standardized became Medicare and insurance fees are nation wide.  Averages can be determined, but there are vast differences based on the areas and individual doctors involved. 

Rand Survey on the changes on how one views chiropractors stated that chiropractors are more accepted but they charge a lot because they may see the patient more often.   This is very misleading.  First, there is no equality and no governmental standard for chiropractors in the health care system for an equal playing field.  Second, for anyone to achieve results, care must be understood as a process.  Actually doctor contact time is far more expensive for a MD, and far more expensive for the patient either through insurance or out of pocket. Third, chiropractors must eventually be self established which often takes a long time to acquire the equipment, build a patient base from zero, and acquire other necessary resources. It's much closer to the income potential of a PT, because chiropractic have far less financial diversities as MD in referrals and medical testing supported by insurers.
It works out that 50% of all chiropractors (new or old) fail; it may well be that 50% of licensed chiropractor fail while a greater number fail before being licensed and/or approved by any insurer.  50% fail not because they are "failures", but, because there are no readily available income opportunities equivalent to their investment.  In 2013, a starting licensed chiropractor may work for an established chiropractor to only make on average $35,000.  They invested $250,000 in school debt for chiropractic post education for the total equivalent education of a M.D.  Can you imagine;  this is for only $35,000 and a more than 50% chance of failure?  How long and at what total income loss?  I am sure that they could have made a much better income during the four additional post graduate years while trying many years to become established. 

At best, an established chiropractor can make $130,000, but I have seen it take ten years to become independently established, if ever.  

Most medical doctors now receive checks and work in large clinics and hospitals receiving salaries with numerous other doctors sharing or even escaping large overhead; this is very different from a generation ago.  I recall a young doctor friend of mine working many years for nursing homes while building his private practice while having hospital hours; these options do not exist for a young chiropractor. The starting M.D. makes $190,000 a year, over $100,000 more for a similar investment.  A starting pharmacist has no clinical doctorate but makes $75,000-$85,000 right away for an undergraduate education and little investment.  The established GP makes $190,000 in a medical general practice, while an established Specialist makes $340,000.  This specialist opportunity only is allowed in medicine, and is contrived only to increase costs much like a teacher gets paid more by consuming university coursework  that increases their income.  This Specialist opportunity to double one's income exists in the medical community through access to high insurance procedures where there is no similar equivalent with chiropractors where there is no financial reward for any special expertise.  High cost procedures determine your higher income--no single chiropractic procedure with BCBS exceeds $30, no matter your training or expertise.

In summary, medical doctors exclusively are in a system that more easily increases their income potential without being further limited to the number of patients seen in day.

A physical therapist is most similar in performing "physical medicine" as does a chiropractor; most PT's are employed and must be "referred" patients by their clinical medical doctors.  Like a chiropractor, they do perform similar codes but are often most overseen by the referring clinical doctor.  This is why they have come to resent their status and what they believe are limited incomes.  If, however, they have advanced degrees, they are never considered "clinical doctorates" so their investment is most often at a master's or PhD level, far less income potential and time investment than a clinical medical doctorate designed exclusively to offer certain coursework and privilege.  Except for chiropractors, any nurse and therapist are intentionally excluded from receiving a clinical doctorate unless educationally they can start the process all over again.

Except for In 2014, the lowest pay for a PT was $56,800, as a salary, while the established average was $83,900.  The average insurance for a PT contact visit pays $160.00, while the equivalent  same average chiropractic visit pays $120.  The PT can generate more and always has more visits, but they generally work for a clinic or hospital so they make less, since they do not own the business or are allowed to generate the patients.  This is similar to the recent elevated status of Nurse Practitioners; they may receive less income as employees to increase the clinical doctors' contact productivity.  It's always confusing to keep track of everyone who gets a piece of the action in the medical community. Essentially, there exists a large semi-professional community that serves the public for the medical doctor increasing the overall number of patients not requiring the doctor's contact time.  This creates an opportunity for larger incomes.

It's wrong to think that an MD makes approximately $100 a visit, yet can see enough patients to make $340 K a year.  If they do not promote high income testing and prescriptions through insurance, they would have to struggle like chiropractors.  In a way, they are subscritized.

In 2013, there were 1,045,910 medical doctors. 1/4 of these doctors receive overseas degrees as to lower investment costs and lower academic restrictions.  The greatest number of specialists are psychiatrists, but I suspect that the highest paid are oncologists or surgeons, those with the big ticket procedural encounters.  Certainly, smaller costs mean less for whatever profession you elect given we all have only the same limitation of time. 

Even though it often seems like there are many chiropractors, because we see the road signs, but really each sign generally means only one person.  Any given hospital supports hundreds of medical practices.  In contrast, it is around 10:1.  This statistic is wrong, because practicing chiropractors still in business makes it 20:1. Chiropractors licenses totaled 92,930, that's just one smaller city in all of the United States.  There are nearly a million MDs in the United States.

Considering these factors, 120 years of chiropractic survival to date is impressive but not encouraging given the vast network of hospitals, medical equipment sales, professional support staff of nurses, techs, and aides,  medical universities, professors, drug corporations, collections and clerical, Samba, drug sales staff, employees, research scientists, medical journals, Surgeon General, editors, associations, CEU systems, government supported agencies like Medicare, Medicaid, VA, FDA, Workman' Comp, Media supported drug ads and actors, private insurance networks, senior medical devices, supplementals, and the many more.  When do you ever think you'll get the truth about your health, when so many others are dependent financially on the present system and its doctors?   

The biggest incomes are made by administrators, CEO's, drug and medical equipment salespeople, lobbyists, politicians, and Board of Directors--not doctors, certainly not chiropractors.


Your Subtitle text

Chiropractic

In accordance to federal case law, the chiropractor has been determined to be a "separate and distinct" health care physician.  This would mean that the chiropractor is not considered to be part of the medical community; thereby chiropractors see patients without requiring any referral.  Chiropractors may well work in harmony with a medical doctor to help his patients.  Chiropractors are licensed in all states; thereby determining that each state has authority over their scope of practice and how they are to be examined. 

All chiropractic schools are accredited by the same agencies by region as are all state universities and private institutions, such as North Central for University of Michigan or Southern Association for Auburn University.  Additionally, each college maintains accreditation from a national chiropractic board of examiners.  The Doctor of Chiropractic degree is an accredited post graduate degree determined to be a clinical doctorate degree of the same consideration as a D.O., M.D., or D.D.S., regarding the nature of the coursework.  Any university can, for example, have a clinical doctorate teach anatomy up to the Master's degree level and be considered adhering to all regional accrediting agencies.   All programs over the last 100 years have changed adding coursework and prequalifications; chiropractic is no different.

Chiropractors must successfully pay for, travel to, and complete 4 National Board Examinations before passing a state examination to be able to obtain licensure.  Only two schools train Naturopathic Doctors (ND)  to the same standards, since only these schools additionally meet M.D. clinical doctorate standards, and seldom do we see any of their graduates in our area.  Most ND schools are not accredited and have no board of examiners; their programs are often taken online for only few thousand dollars, while it costs over $250,000 to complete a clinical doctorate degree for the first four years of post graduate work going full time throughout the years.  Few if any can do this while working any other career.  The cost and loss of income add up to an enormous investment. 

Chiropractic was started by a magnetic healer, DD. Palmer, in a time when it seems by today's standards anyone with a elementary education could go to medical school or any school, but it was professionalized by his son, DJ. Palmer.  He built it into a rigorous school in Davenport, IA where he first introduced radiographs, a first class state of the art therapy clinic, and performed volumes of research.  Early in its history, many of the osteopaths from the Missouri osteopathic school and the chiropractic school maintained degrees in both disciplines sharing in their mutual respect for physical and functional medicine and their disregard for medicine.  Although on the surface, some view the adjustments taught to osteopaths as the same as to chiropractors; however, they are very different.  This was the reasoning for these early doctors to train together and learn the values of each.   Few recall that osteopaths and medical doctor refused to share hospitals and operated very critically toward each other until the late 1960's.  Today,  few know this, even the osteopaths, since they have in the last few generations become more and more part of the medical community. 

Chiropractors have managed to maintain its "separate and distinct' status under more recent decades of persecution and the federally supported monopolization of the industry by the AMA.  In 1987, chiropractors won their case in federal court showing this to be true.   It's quite clear, however, that there is no equity in our access to federal funds and accordingly to the private health care system. 

CHIROPRACTORS ARE LIKELY TO ASSOCIATE WITH

WHOLISTICAL

NATURAL

INNATE INTELLIGENCE

ORGANIC RATHER THAN INORGANIC

BELIEF RATHER THAN HUMANISTIC

QUANTUM RATHER THAN NEWTONIAN

ALTERNATIVES TO ESTABLISHED MEDICAL PROTOCOLS

INTEGRATED AND FUNCTIONAL

LIFESTYLE AND ENVIRONMENTAL CAUSES FOR ILLNESS

DYNAMIC (MOTION) RATHER THAN STATIC (PRONE)

 


Being a physician can be very confusing to the public.  There exists many different points of view on how  one can practice.  It would seem that if we graduated from essentially the same clinical doctoral studies we all would be on the same page.  This is not true.  Medical doctors dispute other medical doctors, so do chiropractors dispute other chiropractors, even from the same schools.  Even the chiropractic college one attends implies a certain approach, training, and philosophy.  Any physician could consider himself to be an Alternative or Integrated physician; a MD or DO could  consider himself to be an Environmental, Orthomolecular, or Functional physician as well.  A chiropractor could be Upper Cervical or Full Spine.  It is important, however, to understand that each physician is telling you something about their philosophy and preconceptions regarding healing.  This will influence their approach to solving your problem.

Look to the physician's affiliations.  Most of these descriptors to their practice are not areas where they received additional university training; they are areas where the physicians have expanded upon  their own self-education on who they value for research, and how they solve problems for their patients.  What you see most are medical doctors who follow to the letter of the AMA protocols for a defined diagnosis, and what you are most likely to find are full spine chiropractors performing what seems to be the same adjustments in a short period of time, over and over again. 

Whether true or not, most all physicians believe that they are helping their patients and are providing a viable avenue.  Some, however, are very intolerant to any implied criticism and even the right of another with equal legal stature to even practice.  Therefore, it is ultimately important that the patient have equal financial access along with personal  and religious freedom to choose for themselves.  In Alabama, the chiropractor is legally referred to as a chiropractic physician. The final word for all physicians  in humbling a medical physician best comes from Hippocrates, " AT FIRST DO NO HARM", thereby  implying that the body and its design provide for the best healing.  Of all physicians, chiropractors pay the least for malpractice insurance; they are least likely to do harm according to the actuaries.  It is not because of chiropractors that the 3rd leading cause of death nationwide is latrogenic, because that's strictly a medical activity, well intended or accidental. 

There is only one right answer to a problem, but in health care, if you elect to see many, you are confronted with many who claim to have the right answer.  They are all professionals, they learned from the same texts, and they were taught by similarly educated professors.  


TWO HARD FACTS ABOUT HEALTH CARE


1. Government, attorneys, and insurance have only one way to make money and still keep the consumer happy, and that is to take advantage of the provider.  In all cases, the provider's fees are reduced while all other costs go up.  Medical expenses are for the most part subsidized and/or paid for by the healthy, and the physician nets less and less.  Providers find that they cannot accept assignment for some because of the financial risks, and many victims go without treatment, especially those electing chiropractic care.

2. As the fees go down and the costs go up, patients will be expected to wait longer for care and will be rushed through protocols.  New protocols will be created to make it that you spend less time with the physician.  Physician tasks will be transferred to others, and more and more physicians will be rubber stamps.  The trend is to have nurses and therapists given traditionally and clinically established doctor oriented tasks.  Assistants will be performing the treatments so the doctor can oversee greater numbers of patients, since the net on each is so little given the overhead costs.  Smaller private practices will fade away, and "quick fix" clinics will be all over the place.  They will make it seem that it is a good thing to be quick, fast, and express.  In France's socialized medical community, the doctors went to the streets in protest over how little they were making for the risks and costs. 

How can a chiropractor see 100 patients a day?  They can only do it with part time lower paid help, and spending very little time with the patients.   There is no time for inquiry, small talk, and privacy.  The relationship can only become less and less intimate and professional.


Dr. Katherine has to battle these trends, because it is so contrary to her personality and beliefs.