The most obvious difference between doctors of chiropractic (DC’s) and physical therapists (PT’s) is virtually all DC’s utilize some form of manipulation to restore joint function, whereas only a very small percentage of PT’s utilize manipulation and virtually none of them have nearly as much experience “adjusting” patients or, the training to determine how and when to adjust for ultimate results go beyond just pain relief. Another very important difference is the education curriculum of chiropractors includes many class hours in physiology, pathology, clinical examination, radiology, laboratory testing and interpretation and diagnosis – these are not included in the PT educational process. DPT programs may now include some or all of these areas of education for Physical Therapists and allows them to offer a more broad knowledgebase than in the past. Currently only the MD, DO, and DC are identified as a physician by Medicare and the medical community at large.
Perhaps even more important, chiropractors are accessible to the general public – that is, a referral from a medical doctor is not required. This is not the case for physical therapy as a medical referral is required and, the medical doctor can limit the amount of care rendered. This is an area that the physical therapy groups are currently working hard to change with many debated issues being presented. There are now some states that allow direct access of patients to doctors of physical therapy (DPT’s), a new program created to improve the limited accessibility to PT’s. Although a PT may have direct access laws in place to enjoy being a primary contact for a patient, it is critical for the patient to know that a physician referral is commonly needed for insurance providers to agree to pay for the PT services that will be rendered.
With the debate raging on about health care reform, a pilot study indicating chiropractic care and other physical medicine approaches may reduce costs is VERY TIMELY!
In 2008, Welllmark Blue Cross and Blue Shield conducted a 1-year pilot program designed to study the patient quality of care. The researchers concluded that the use of chiropractic and other physical medicine services significantly improved clinical outcomes and reduced health care costs. The 2008 Iowa and South Dakota pilot study included 238 chiropractors, physical therapists and occupational therapists that provided care to 5500 Wellmark patients with musculoskeletal disorders. They reported 89% of all patients receiving physical mediclne services improved at least 30% within 30 days. These statistics were so impressive that they decided to continue the program. Supporters of chiropractic treatment praised the findings, saying that the cost-effectiveness of the method has been documented in several studies.
The president of the American Chiropractic Association, Glenn Manceaux, referred to a 2005 study published in the Journal of Manipulative and Physiological Therapeutics that found chiropractic and medical care have comparable costs for treating chronic low-back pain, with chiropractic care producing significantly better outcomes. Similarly, a study published in a 2003 edition of Spine medical journal found that manual manipulation provides better short-term relief of chronic spinal pain than a variety of medications, he said – “Especially during the health care reform debate, it’s important that chiropractic and other conservative care methods are taken into serious consideration as a cost-effective alternative to the utilization of expensive surgery and hospital-based care.”