One question, how in the world did the chiropractors ever land the "Doctor" designation? We don't diagnose anything, except the elusive "subluxation". Problem is, most every "doc" would diagnose a different area of subluxation on the same patient. We're "witch doctors", in other words, "which subluxation am I going to diagnose today?" There is no interexaminer reliability. I've had patients give themselves away by saying things like, "well, let me go see my doctor about this....", okay, you do that.
So even patients don't take the "doctor" designation seriously. I just don't see "doctors" giving away free heart exams and gyno visits at the mall, I'm sorry. It probably had something to do with getting out from under the A.M.A. Nazis, but I would feel much better if we could be designated as "CMT,s", Chiropractic Manipulative Therapists, if we could keep the primary provider status. When a patient says, "hey Doc!", I cringe a little bit.
Even the "good" chiropractors have a hard time being compensated monetarily in proportion to their time and effort spent in becoming skilled in joint manipulation. When I was in school I remember there were some very capable DC's teaching class. These guys could really adjust a spine-really fix you up. They were making, maybe 30k. It just didn't make sense. Why weren't they out working their booming practices? I mean, they were obviously good doctors, right?
I remember in practice a few years back, a mother brought in her autistic teenage boy because he had dislocated his shoulder somehow, and his arm was hanging, useless, by his side. I proceeded to carefully place the arm back in the socket using the Hearon maneuver, which I had spent many hours studying and practicing. The liability for performing this maneuver in the office was huge, I'm sure, but I set the arm perfectly, and it made a loud "pop" as it returned to its normal position. The mother just about kissed me on the lips. Then I taped up the shoulder and gave the mother some exercises to tighten up the boy's shoulder muscles. The final compensation for all this? $35.00, the usual cost per visit.
It was still worth it though, because that is one of the very few times in practice that I felt like a real doctor, you know, that feeling that I've really done something valuable with my day. When I was in school, I thought every day would be like that, but it's not. Nobody puts a value on our services. Most of the time, if people have a real problem, they go to an M.D. or other specialist, not a chiropractor. So we have these high dollar, four year degrees, that don't pay for themselves. Then we got everybody calling us "Doc", as we climb into our five year old econobox cars, and go to our little apartments where we barely make the rent. That's just not acceptable.
85% of the time, this is a very unrewarding, and monotonous business. It also kind of sucks, the per-visit based nature of the business. It's all about the numbers. As a result, we rush patients in and out, crack their backs the same way every time, for no particular good reason, and spend all our time chasing patient numbers. It's just monotonous as hell after a few months time.
I'll tell you what would make the profession fun again is if they would let us bill for each chiropractic adjustment like a surgeon charges for surgical procedures. We could guarantee each adjustment for one year's time. Let me see, how about $1,000 to reset a dislocated shoulder, $750 for an elbow adjustment, $500 for a wrist or a knee, $1,200 to fix a neck, pelvic adjustments $350, because they're so easy, and so-on. Reducing a lumbar disc rupture should be worth, at least..........$5,000, just for the pain relief part. This per-visit stuff is crap, really. It's a waste of everybody's time.
I have long suspected that the chiropractic profession has survived this long because it allows academically marginal students from rich families to appear like they are actually gainfully employed. Think about it. If the practice doesn't make any money for a few years, their families can just keep throwing money at the business until the doctor figures out how to run a profitable practice, or hires enough management expertise to get it done. Meanwhile, the chiropractor appears to actually be doing something useful all day, even if the practice doesn't make a dime. It's the perfect cover for average students from rich families to appear academically successful.
Meanwhile, those of us who actually need to survive on what we make, get killed the first few years by expenses while we're trying to get a few loyal patients from the 7% (the latest data says 5%) of the population that pay, stay, and refer. During that period, many of us end up divorced, with ulcers, or worse. Maybe some of us do figure it out before the student loan people hunt us down and take our homes. It's a race against time. The question is, why volunteer for such a situation in the first place? There are so many better ways to blow through 100 grand! The schools should either lower tuition, drop out of the student loan program, or both. See your career counselor.
Chiropractic is great (but extremely tough), as a cash practice, but when they got involved with the student loan program, and whored out to the insurance companies, they changed a nice profession into a sleaze profession.
Another little known fact about student loan debt, generally not publicized, is that you are limited to a yearly tax write off for interest payments on that debt to just $2,500 max. This means that if you have just $100,000 in student loan debt after graduation from chiropractic school, with a 5% interest rate, not-unreasonable figures these days, or even ten years ago, you will most likely have to pay income taxes on money you already sent to the student loan payments for the many years most grads will take to pay back the loans. (Don't forget, you already took four years off from the work force for chiro school) Will you really enjoy paying taxes on earnings you already spent on student loan interest? I think not. This also means that to accelerate your payments at a decent rate, you will have to pay taxes on anything over $2,500 sent in for that year. A losing battle indeed.
Idea; how about we get these schools to lower the tuition by about 50%? Better yet, Let's just add spinal manipulation ("adjusting skills") to the curriculum of certain existing, and more mainstream health care fields, like P.T. or M.D degrees? We have to shut these chiropractic schools down. They're bad news!
Getting back to the situation with chiropractic school loan debt, hopefully, nothing else comes up on the financial front for a few or 20 years while you try to pay it back. Getting married? Good luck. Having kids? A dream at best. Get sick? Hope you're paid up on the health insurance, and don't forget disability insurance. Somebody has to keep the office open. Good luck paying the loans down anytime soon. For those of you who have read the previous posts, but are still considering attending chiropractic school, please see the video clip from this recent story from the November 20, 2006 issue of USA Today: (link) young and in debt.
Remember in the movie, "Born on the 4th of July", when the character, Ron Kovic, comes back from 'Nam, and his his life is totally screwed up, but nobody who wasn't there can understand what he's going through? He signed up for one thing, but they gave him something completely different. By the time he figured out what was going on, he was in too deep.
That's what chiropractic school is like. By the time most students graduate from the program, their lives are all screwed up. It just snowballs as time goes on, but nobody understands - they just think it's you. "But you're a doctor............" I am so freaking sick of hearing that from numb-nuts who just don't get it.
I think it would take a movie to clearly explain what's going on with this profession and the student loan, insurance, and health care rackets. Problem is, nobody in the corporate/medical/legal/big pharma complex wants this information distributed.
Re: "I’m Screwed 4 Life" – Did you know that…? « Reply #4 on Jul 20, 2008, 10:53pm »
In my case I've been pleasantly surprised to see the amount of support my friends and family have for me since throwing in the towel. Most of my undergrad friends never really showed much interest in my chiropractic job anyway, and I could tell they thought it was kind of phony. I remember back in 2000 before I left for Palmer I would tell everyone proudly that I was going to chiropractic school. I now can interpret that weird look that came over their faces. "Why don't you just go to med school," they would suggest.
Luckily for me, the trail into the graduate program I've just applied for was blazed by an ex-chiro. I couldn't believe how understanding they were in the admissions department. They had all heard the story before over the last few years. But this being said, I still like to keep quiet about the subject. I'm wary of the folks who 'love their chiropractor' and wouldn't understand. I still have trouble explaining why I left in a moderate tone. I either rip on chiropractic way too bitterly or I'm too nice about it and then some folks try to talk you back into it. But I'll learn in time.
« Last Edit: Jul 21, 2008, 12:31am by Younghypnotiq »
The most amazing thing about getting involved in chiropractic is the enormity of what you have to go through to start making a living. Right now, there are no less than 4 National Board tests that are required as one of the many requirements to get licensed in some lucky state. Part 4 alone is a $1,200 test, plus travel and lodging. Add the fact that the schools stretch two years of education into four-plus to drain your student loans, and make clinical requirements so difficult that many students pay patients to come in, just to get themselves through the program before doomsday arrives.
When I was at Life College, 75% of the interns were paying patients to come in, so they could fulfill clinic requirements. Patients were then "sold" to new interns entering clinic. Too bad if you had no extra cash, or didn't kiss the right butt to get hand-me down patients. Many students left out of the loop found themselves flunking clinic three or four times, or more, at a cost of $600 per quarter. Add to this a complete lack of parking spaces anywhere near the clinic, as was the norm at Life, and you have a SNAFU (Situation Normal, All F----d Up).
This might be acceptable at a public school, but to go into debt and pay large tuition to go through this experience has to be the stupidest move ever. If you are going to one of these schools, be sure and take a good hard look at their student clinic situation.
If you have to pay patients to come into student clinic, is this really a good idea, to go into this profession? With the size of tuition at these schools, you'd think a six-figure income is a given, but it's not, that's for sure. Just look at the cars parked in the instructor section at any chiropractic school. How many of these vehicles are over five years old, or just cheap and rusty? This will give you an idea of whether you're making the right move.
After they graduate, most people find that the schools have laid a student loan debt on them that they are ill-prepared to pay off anytime soon with the usual chiropractor's income. This leads to stress, frustration, and eventually, broken homes and families. One of the results of this mass desperation is the existence of many management companies vying for another 20 or 30 grand, or more, in exchange for teaching you how to actually sell chiropractic, and run the business.
Their game usually goes like this:
1. Promise you the world.
2. You, spending many weekends away at some overpriced hotel while they cram their management system down your throat.
3. Selling you some wonder-gadget that they require as part of their program.
4. You, many weeks later, back at your practice with your wonder-gadget, with about $50,000 less in the bank.
If you implement their system, and things work out, great. However, if you get poor or no results, they blame you, and your wonder gadget ends up on Ebay, at a huge discount from your original purchase price. Don't believe me? Just check out a certain $120,000 spinal traction unit, regularly for sale for about half that on the Ebay site. Go ahead, go look it up under: DRX-9000.
Before you start looking for that dream house, take a look at these little known facts about the student loan program (link).
As you will find, more and more often, this is no longer America, it is now "SCAMerica".
When you begin school, you really have no clue as to what you're getting into. Even in the best case scenario, give yourself at least ten years, from the day you start chiropractic school, until you begin making a respectable living; you know, the wife, the house, the kids, the dog. School is just the beginning. Don't expect much of a reward anytime soon after graduation. That's a lot of years of just getting by before any kind of payoff. Are you a Marathon Man?
This will be a thankless experience. There's the student loan burden, following you for decades in some cases. There's the lack of help at tax time if you pay more than $2,500 toward your loans. If you like women, school is mostly guys. Then, when you go to continuing education events, more guys.
If you like to work around intelligent people, better forget about it. Also, in practice, you don't get to meet many successful professional types, or make good business connections. Your patients are usually going nowhere, because they have time to come in three times a week forever! After a few years, you can feel yourself getting dumber….it's damned depressing.
Don't forget the "religious aspect" of chiropractic, in that the field covers its own tracks by making it a sin almost, to complain about anything related to the profession. If you don't harp on "subluxation" and its effects, you're labeled a "non-believer". We have all witnessed the actions of religious fanatics, and how they can commit the most horrific acts in the name of their God. Never mind that subluxation is ill-defined, and that most health effects attributed to it have no hard proof to back them up.
One of the tactics the seminar shysters have come up with in using the "subluxation" term is to come up with their own definition of subluxation, and then grow a whole seminar industry around their definition.
For example, Biophysics claims that a subluxation is an imperfect posture of the body. They base this on the research of their so-called mathematical genius/leader, who claims that the ideal-perfect curvature in different areas of the spine is based upon a certain degree measurement of part of a perfect circle, and that anyone whose spine deviates from this configuration is subluxated, and needs to have their spine bent back into the ideal posture! This outfit subsequently sells seminars, videos, and medieval-like spine racks to use on your patients to bend their spines back to normal.
Another group of whackos claims that anyone with uneven leg lengths is subluxated, and has a variety of muscle tests that, if testing results in either leg pulling short, even slightly, on a prone patient, is a sign that you are definitely subluxated. They then use a "clicker" instrument to poke different areas of the spine until the legs even out. That means you're cured (for that day anyways). They also have a variety of seminars, equipment, and videos to sell you. And the list goes on….
If you're not in the subluxation camp, you have no other choice but to run a personal injury clinic, which is almost a worse way to go. You see the same patients, day in and day out, for months on end while they build a case for insurance or lawsuit claims. Never mind that most of them aren't really hurt, and that it's unethical. It's all about the money. We all know that whores do it just for the money, and you will feel a little dirty about every case you know is a scam, just like a whore. If you want to work the system, you should have just been a lawyer. Why go half way?
If you really want to know for sure whether chiropractic practice is for you, just spend a week with an existing DC in practice. A week is really nothing compared to the length of the program itself, so do it. I guarantee you, after a week of real world stuff, you'll see the light.
I am continually frustrated by the downtime in chiropractic, time spent just looking out the window. There are busy periods, but the slow periods can be depressing. Make sure you have Cable TV and high speed internet in your office, for mental stimulation. There is always your marketing program to work on. Getting new patients is a constant battle.
If you try to switch careers, it's just about impossible. If you have "chiropractor" anywhere on your resume, it's like job repellent.
Things have slowed down this year generally, in the profession. I sense an overall recession in the chiropractic field. I have never heard of so many chiropractors who are barely paying their bills. It could be the Bush administration's pro-corporate stance, which means insurance companies can deny chiropractor's payment, and get away with it. I know more than a few DC's who play Mr. Mom, while the wife brings in the serious cash. Do we call this a "chi-recession"?
Maybe the greed of the schools in the 90's has finally caught up with them, as a whole. The robbing of the student loan program, the massive debt, the lack of entrance standards. The 90's were shameless, what they did to this profession, the schools in league with the student loan organizations. Maybe it's payback time, soon. Just check the number of practices for sale on chiroweb.
After a few years in practice, even if you're doing well financially, you might find yourself praying for a nice UPS job, a job where everything is structured, all tasks are mapped out and planned, and you get paid for your work. In chiropractic, just the day to day business routine often gets confusing and disorganized. After all, you're at the mercy of patients who think nothing of missed appointments, not paying, and insurance companies who are cutting benefits to the bone. Hey, I'm just talking from experience. Maybe you're making a good decision for you. Just think about it.
Re: "I’m Screwed 4 Life" – Did you know that…? « Reply #7 on Aug 8, 2008, 8:29am »
Wow, what a great blog that screwed4life has there. I wish there where more blogs like that, anyone know of more? I'd like to compile a little list of such resources.
Re: "I’m Screwed 4 Life" – Did you know that…? « Reply #9 on Sept 10, 2008, 1:21am »
WOW I stumbled onto this web site looking at the questionable use of laser therapy. I lurked here for days and finally had to join and post. I feel sorry for you all. It seems that it didn't work out for any of you but I must post that this is a great profession for me. Those who stumble onto this board ought to know that all is not always as stated by those who struck out and have posted here. I've been in practice for 23 years and am blessed with a near closed practice and am limited to almost exclusively MD, Ortho and physio referred new patients as well as MD's as patients. It takes hard work, NO gimmicks and great MSK diagnostic skills. My experience has been that those from my class who can't dx and have poor treatment skills ended up resorting to practice management gimmicks that ended up burning them in the ass. That being said the flavor of this board seems to be the downtrodden and those who bought into the make money from your degree logic. I feel for you all but really both sides of the equation should be presented to potential students in a fair and unbiased manner. I don't expect to change anyone but this is just my vent.
I've been in practice for 23 years and am blessed with a near closed practice and am limited to almost exclusively MD, Ortho and physio referred new patients as well as MD's as patients. It takes hard work, NO gimmicks and great MSK diagnostic skills. My experience has been that those from my class who can't dx and have poor treatment skills ended up resorting to practice management gimmicks that ended up burning them in the ass. That being said the flavor of this board seems to be the downtrodden and those who bought into the make money from your degree logic. I feel for you all but really both sides of the equation should be presented to potential students in a fair and unbiased manner. I don't expect to change anyone but this is just my vent.
It does seem to be common that older chiropractors (and doctors as well) are largely unaware of the nature of evidence and where to find it in the context of "evidence-based practice" and of what it should mean to a clinical discipline. I don't believe it is taught at any chiropractic college and has only recently become a part of undergraduate medical curricula. The attitude “I am successful because I have a busy practice and because medical professionals refer to me” is typical of someone with a complete ignorance of basic science. This statement does not necessarily describe a good clinician, only a popular one. It is not yet an ethical problem because it suggests that the individual is unaware of what constitutes evidence, how it relates to good practice and of their obligation to deliver it. Although, someone with good diagnostic skills is venturing closer to unethical behaviour than a subluxation-oriented chiropractor because the former has named an actual lesion that probably has body of evidence regarding its management. A simple reason that a chiropractor claiming to be a good clinician is ignorant of evidence-based practice is that manipulation is not a recommended intervention for any musculoskeletal complaint in any Cochrane Review (which are the best systematic reviews of evidence available). In most cases it is no less effective than other interventions (see http://www.cochrane.org/reviews/en/ab000447.html for Spinal manipulative therapy for low-back pain and http://www.cochrane.org/reviews/en/ab004249.html for Manipulation and mobilisation for mechanical neck disorders). The delivery of placebo is a complex issue so it is an unsubstantiated leap to suggest that the members of this forum were unsuccessful because they lacked diagnostic skill. I would suggest that the inference that chiropractors fail because they are poor diagnosticians is false because it lacks evidence and it lacks a reasonable mechanism. More likely, successful chiropractors achieve a greater placebo effect because they have a higher degree of belief in their diagnosis and their treatment. This has been shown to be truein other contexts (see Moerman D.E., Harrington A. Making space for the placebo effect in pain medicine (2005) Seminars in Pain Medicine, 3 (1 SPEC. ISS.), pp. 2-6.) and it is by no means a bad thing. What prospective students need to know is that the way we assess the validity of treatments has changed substantially in the last 20 years. They need to know that most of the people who teach at chiropractic colleges around the world do not teach evidence-based practice (or the chiropractic degree would be very short) and many are like this person and do not even understand the concepts involved. An excellent place to research any medical or CAM intervention is http://www.cochrane.org/ , where you will find systematic reviews of studies of a huge range of interventions. Scientific enquiry is a method, not an opinion. Why should prospective students hear nonsense explanations, based on uneducated opinions when there is plenty of well-researched data that is freely available for them to read?
Re: "I’m Screwed 4 Life" – Did you know that…? « Reply #11 on Sept 10, 2008, 8:44am »
backdc, this is a "skeptical" chiropractic website. Are you skeptical about anything "chiropractic"? Any chiropractic technique? Any chiropractic claim? Anything?
WOW I stumbled onto this web site looking at the questionable use of laser therapy. I lurked here for days and finally had to join and post. I feel sorry for you all. It seems that it didn't work out for any of you but I must post that this is a great profession for me. Those who stumble onto this board ought to know that all is not always as stated by those who struck out and have posted here. I've been in practice for 23 years and am blessed with a near closed practice and am limited to almost exclusively MD, Ortho and physio referred new patients as well as MD's as patients. It takes hard work, NO gimmicks and great MSK diagnostic skills. My experience has been that those from my class who can't dx and have poor treatment skills ended up resorting to practice management gimmicks that ended up burning them in the ass. That being said the flavor of this board seems to be the downtrodden and those who bought into the make money from your degree logic. I feel for you all but really both sides of the equation should be presented to potential students in a fair and unbiased manner. I don't expect to change anyone but this is just my vent.
Welcome Backdc,
Please explain how the chiro profession has been good to you... What practice management consultants have you used? What techniques do you use?
Keep in mind there are perspective chiro students reading this website. Considering all the student loan debt these students will accrue throughout their life and the difficulty having what the majority of people consider an ethical chiropractic career. Would you recommend a chiro career to someone in todays market?
Tyler Durden: You are not special. You are not a beautiful or unique snowflake. You're the same decaying organic matter as everything else.
"You may fool all the people some of the time; you can even fool some of the people all the time; but you cant fool all of the people all the time." -Abraham Lincoln
The greatest trick the Devil ever pulled was convincing the world he didn't exist.
I've been in practice for 23 years and am blessed with a near closed practice and am limited to almost exclusively MD, Ortho and physio referred new patients as well as MD's as patients. It takes hard work, NO gimmicks and great MSK diagnostic skills. My experience has been that those from my class who can't dx and have poor treatment skills ended up resorting to practice management gimmicks that ended up burning them in the ass. That being said the flavor of this board seems to be the downtrodden and those who bought into the make money from your degree logic. I feel for you all but really both sides of the equation should be presented to potential students in a fair and unbiased manner. I don't expect to change anyone but this is just my vent.
It does seem to be common that older chiropractors (and doctors as well) are largely unaware of the nature of evidence and where to find it in the context of "evidence-based practice" and of what it should mean to a clinical discipline. I don't believe it is taught at any chiropractic college and has only recently become a part of undergraduate medical curricula. The attitude “I am successful because I have a busy practice and because medical professionals refer to me” is typical of someone with a complete ignorance of basic science. This statement does not necessarily describe a good clinician, only a popular one. It is not yet an ethical problem because it suggests that the individual is unaware of what constitutes evidence, how it relates to good practice and of their obligation to deliver it. Although, someone with good diagnostic skills is venturing closer to unethical behaviour than a subluxation-oriented chiropractor because the former has named an actual lesion that probably has body of evidence regarding its management. A simple reason that a chiropractor claiming to be a good clinician is ignorant of evidence-based practice is that manipulation is not a recommended intervention for any musculoskeletal complaint in any Cochrane Review (which are the best systematic reviews of evidence available). In most cases it is no less effective than other interventions (see http://www.cochrane.org/reviews/en/ab000447.html for Spinal manipulative therapy for low-back pain and http://www.cochrane.org/reviews/en/ab004249.html for Manipulation and mobilisation for mechanical neck disorders). The delivery of placebo is a complex issue so it is an unsubstantiated leap to suggest that the members of this forum were unsuccessful because they lacked diagnostic skill. I would suggest that the inference that chiropractors fail because they are poor diagnosticians is false because it lacks evidence and it lacks a reasonable mechanism. More likely, successful chiropractors achieve a greater placebo effect because they have a higher degree of belief in their diagnosis and their treatment. This has been shown to be truein other contexts (see Moerman D.E., Harrington A. Making space for the placebo effect in pain medicine (2005) Seminars in Pain Medicine, 3 (1 SPEC. ISS.), pp. 2-6.) and it is by no means a bad thing. What prospective students need to know is that the way we assess the validity of treatments has changed substantially in the last 20 years. They need to know that most of the people who teach at chiropractic colleges around the world do not teach evidence-based practice (or the chiropractic degree would be very short) and many are like this person and do not even understand the concepts involved. An excellent place to research any medical or CAM intervention is http://www.cochrane.org/ , where you will find systematic reviews of studies of a huge range of interventions. Scientific enquiry is a method, not an opinion. Why should prospective students hear nonsense explanations, based on uneducated opinions when there is plenty of well-researched data that is freely available for them to read?
How interesting that you have assumed much about my treatment apprroach and practise before asking how practise is conducted. While the use of outcome measures is a recent approach for many they have been part of my day to day rituals for 8 years. No not everyone gets manipulation you need to apply prediction rules to determine who it will help and not manip those that don't fit. Informed consent has happened for 18 years on all patients. Modalities are seldom turned on. The scope and nature of practise constantly evolve as the evidence from jmpt spine jospt and manual medicine journals are read. Low tech rehab and pile of patient education are the main stay for all patients. Md's and orthopods don't refer because you are popular, constant written communication is also a must. These referrals are long term results based with average patient visits below6.5 for 20 plus years. The chiros here don't get it and the lurkers from other manual professions don't realize where we do fit in Since you are critical my local hospital privledges don't come with popularity either, nor does the governmental peer review committee appointment I just finished up on. Sorry to sound loud but try not to be critical before you find out the facts.
WOW I stumbled onto this web site looking at the questionable use of laser therapy. I lurked here for days and finally had to join and post. I feel sorry for you all. It seems that it didn't work out for any of you but I must post that this is a great profession for me. Those who stumble onto this board ought to know that all is not always as stated by those who struck out and have posted here. I've been in practice for 23 years and am blessed with a near closed practice and am limited to almost exclusively MD, Ortho and physio referred new patients as well as MD's as patients. It takes hard work, NO gimmicks and great MSK diagnostic skills. My experience has been that those from my class who can't dx and have poor treatment skills ended up resorting to practice management gimmicks that ended up burning them in the ass. That being said the flavor of this board seems to be the downtrodden and those who bought into the make money from your degree logic. I feel for you all but really both sides of the equation should be presented to potential students in a fair and unbiased manner. I don't expect to change anyone but this is just my vent.
Welcome Backdc,
Please explain how the chiro profession has been good to you... What practice management consultants have you used? What techniques do you use?
Keep in mind there are perspective chiro students reading this website. Considering all the student loan debt these students will accrue throughout their life and the difficulty having what the majority of people consider an ethical chiropractic career. Would you recommend a chiro career to someone in todays market?
Thank you
I'll try to answer without going overboard. Obviously I am very fortunate to have my professional life turn out as it did. I acctually transfered out of pre med due to a positive ethical chiro experience. I have never used practise management groups so I can't give much lead there. You will see from my second post that I do not confine myself to a technique and adapt what is currently supported in the literature to a Chiro approach. I am not always successful with every case but can freely refer out the cases that need to be elsewhere. Would I refer prospective students to this profession? A qualified yes. If the prime reason to go is for a title and a great income not on your life. If the student has a good undergrad exposure to biomechanics with their strong desire to be a team player helping patients and have the physical attributes to handle practise then yes. The only practise like adviseI ever read was in college and It was written down as coming from a book by the original Dr.Parker(JIM). It was in an archive section of the library and it went something like...take care of the patient and the practise will take care of it's self.
Re: "I’m Screwed 4 Life" – Did you know that…? « Reply #15 on Sept 10, 2008, 11:17pm »
Parker "took care" of his patients alright, with bizarre chiropractic techniques. He also promoted bizarre chiropractic techniques at his college. No chiropractic technique that is based on the priciples of chiropractic, have ever been shown to be effective in treating anything.
So I'll ask again, backdc, are you skeptical about anything "chiropractic"?
I agree with you on one thing. This is NOT the field to go into if you want to make a good living. As most are aware, the income for chiropractors has been declining for years. Many many have left the field because they were unable to make a decent living. Many, maybe mos,t have left chiropractic once they realized the overwhelming amount of fraud and chicanery that go on.
While the use of outcome measures is a recent approach for many they have been part of my day to day rituals for 8 years. No not everyone gets manipulation you need to apply prediction rules to determine who it will help and not manip those that don't fit. Informed consent has happened for 18 years on all patients. Modalities are seldom turned on. The scope and nature of practise constantly evolve as the evidence from jmpt spine jospt and manual medicine journals are read. Low tech rehab and pile of patient education are the main stay for all patients. Md's and orthopods don't refer because you are popular, constant written communication is also a must. These referrals are long term results based with average patient visits below6.5 for 20 plus years.
I'm sorry, you seem like a nice a chap and that probably helps with your business. But let's be clear that Spine, JMPT and other such journals do not constitute the same level of evidence as a systematic review. I can make assumptions about your practice because I am familiar with the literature and evidence available for managing musculoskeletal conditions. But I am prepared to say that I could have missed something. Please tell me about the literature that has defined the way you practice. In particular, explain why you think the study designs are appropriate for the conclusion. Also, I’d love to hear about negative studies that have shown practices you have discarded as they have been shown to be ineffective. In the mean time, there is a wonderful paper that was published in the Journal of Personality and Social Psychology in 1999 (Vol 77, No 6 pp1121-1134). It is by Justin Kruger and David Dunning and is called “Unskilled and Unaware of It: How Difficulties in Recognising One’s Own Incompetence leads to Inflated Self-Assessments”. It is a great read and interestingly, the authors suggest that as people become more skilled, the more they recognise the limitations of their abilities.
Please explain how the chiro profession has been good to you... What practice management consultants have you used? What techniques do you use?
Keep in mind there are perspective chiro students reading this website. Considering all the student loan debt these students will accrue throughout their life and the difficulty having what the majority of people consider an ethical chiropractic career. Would you recommend a chiro career to someone in todays market?
Thank you
I'll try to answer without going overboard. Obviously I am very fortunate to have my professional life turn out as it did. I acctually transfered out of pre med due to a positive ethical chiro experience. I have never used practise management groups so I can't give much lead there. You will see from my second post that I do not confine myself to a technique and adapt what is currently supported in the literature to a Chiro approach. I am not always successful with every case but can freely refer out the cases that need to be elsewhere. Would I refer prospective students to this profession? A qualified yes. If the prime reason to go is for a title and a great income not on your life. If the student has a good undergrad exposure to biomechanics with their strong desire to be a team player helping patients and have the physical attributes to handle practise then yes. The only practise like adviseI ever read was in college and It was written down as coming from a book by the original Dr.Parker(JIM). It was in an archive section of the library and it went something like...take care of the patient and the practise will take care of it's self.
I don't know how long you have been in the chiro game for but I assume you have no idea what it is like to get out of chiro school with $125,000+ in student loans. That equals $575 a month in SL payments every year for the next 30 years.
That is before you buy a house, car payments ect...
I hope you realize most chiro jobs out of school are full of fraud, quackery, scams and are very low paying. I was offered about $36,000 for my first job.
Put your pride aside. How can you encourage someone to get themselves into this situation?
Tyler Durden: You are not special. You are not a beautiful or unique snowflake. You're the same decaying organic matter as everything else.
"You may fool all the people some of the time; you can even fool some of the people all the time; but you cant fool all of the people all the time." -Abraham Lincoln
The greatest trick the Devil ever pulled was convincing the world he didn't exist.
Re: "I’m Screwed 4 Life" – Did you know that…? « Reply #18 on Sept 11, 2008, 11:00am »
Backdc, I don't know you but I'll say this, Parker is full of crap. Of course, compared to other chiropractic institutions it's not but compared to the reality of the healthcare world it is. Dr. Parker was an interesting character, met him twice. First time he was getting into his Rolls Royce, backed out and underneath his car (at Parker College) was a giganitic pile of cigar/cigarette butts...nice. A "real" healthcare advocate. Second time he came into orientation dressed like Col. Sanders in an all white suit. I literally think he thought he was Ricardo Monteban or Col. Sanders...either way the most ridiculous thing I've ever seen. He talked for hours and somebody finally had to cut him off. So what was Parker? A great doctor? A great chiropractor?
No. He was a salesman. Plain & simple. All the rehashed junk he peddled in his seminars was simply feel good, self help guru, master salesperson junk that just never found it's way into chiropractic until he pushed it in. How did he make his money? Selling chiropractic, that's it. He taught people how to help themselves "to" patients, NOT how to help patients. It's a decent school but not worth the tuition and I imagine none of the chiro schools are worth the tuition they charge considering the prospects after graduation.
This is what gets me just b/c some have enjoyed the financial rewards of being in chiro long enough to have to have ripped off medicare & insurance companies in the 80's & 90's they consider themselves successful "doctors". MOST having gotten their chiro degress when chiro literally took "anybody" in school and didn't even require organic chem classes as pre-req's which ALL professional health degree programs do. In addition, to graduate, these "ol'timers" didn't even have to demonstrate skills in a PIV exam. I doubt if many of thes ol' timers would be able to pass any board exam if it were required to keep your license. Of course we all know the continuing ed is complete bull. I have no idea what CE is like on the medical side but on the chiro side it's an absolute joke.
My point is this. Money aside there is no way to say, as a chiropractor, that you're a successful doctor b/c you are not a "real" doctor (your diff dx skills are crap) and how can one measure success by how well you've deceived people into believing that they suffer from an imaginary illness that only you can treat with an unproven therapy? It's an endless argument...you have to live with your conscience so you tell yourself whatever the heck you need to so you feel like you didn't waste your life, despite the fact you've made a pretty buck doing it. For the rest of us, it just ain't enough to live our lives lying to ourselves as much as we do to the patients.
« Last Edit: Sept 11, 2008, 11:40am by rulerboyz »
One of the more brutal aspects about getting involved in chiropractic is all the wasted time involved. The degree itself is simply a glorified, six month massage therapy certification, stretched out into four long years, with a lot of medical fluff classes added, each with impressive-sounding titles to make students feel very "doctorly".
Then, when you finally get into practice, there is a huge amount of down-time, as getting patients in is usually like pulling teeth, unless you look like the young Christopher Reeves, and there are a lot of bored, but rich, housewives in the area, or are maybe a gorgeous woman with great breasts, working near a truck stop or a steel plant, or are just a super-salesman with a ton of connections in the area. Remember, this business is 'personality-driven', and has nothing to do with 'doctor' skills.
Otherwise, you will be spending a lot of nights and weekends at the mall, handing out free exam flyers and bent pens, as you watch your 100k plus in student loans grow like a weed, and your personal life end up as a long list of ex-spouses and ex-friends.
Regardless, you will eke out a living eventually. One day, you wake up to realize that ten years have just got behind you, and you've built relatively nothing, with really nothing much to look forward to. You've spent all your time chasing patient numbers, paying down your massive student loans, and being chained to your office all day. Hopefully you have planned for this, and have a good backup ready. Just chalk it up to experience, and hope you are still relatively young.
I chanced to drive through Atlanta a few weeks ago on business, and gave in to the temptation to go back and visit the grounds of the former Life College. It has been about 11 or 12 years now, give or take a few months.
I really didn't want to go back there, but I was drawn to the place like one might be drawn to the scene of an accident from long ago, an accident that had forever changed their formerly "normal" life into something of an ongoing nightmare. Maybe, I thought, by going back there, I could somehow awaken from the nightmare, and it would be that same day long ago, and I would get those years back, and I could then change my destiny, take a different road, and change history.
The surrounding neighborhood looked in worse shape, with gang graffiti and motley looking characters hanging around the streets not too far south of the school. Wait a minute......these are perfect patients for student clinic! These are probably the guys we used to pay to come in, or more likely, their children.
I also was alarmed to find homeless types hanging out just off the running trail behind the school gym in the woods, where I used run for exercise with my dog. She is long gone now. We were both here. We were both young. It looks like it might be a good place to get mugged now. I did not hang around to find out.
There is another chiropractic school here now, with a similar name, but supposedly a new school in place. All of Sid's statues are still here. I guess the new owners didn't mind. I would think the new CEO would want the statues replaced with statues of his own likeness, as is the norm with the chiropractic propensity for narcissism.
There is the beautiful gym they built with our student loan money. I guess that was our purpose there, to fund this gym. That means this is technically my gym; our gym. Well, thank you Sid!
I was struck by the lack of a "crowded frenzy" as was the norm when I was enrolled here. There were actually some parking spaces available, even though the main lot was closed. Things looked a bit weathered now, a bit of grass poking through cracks in the pavement here and there. It was a somewhat like walking through Rome I suppose, years after it burned.
I peeked in on some classes in progress-security was quite lax-and they were pleasantly small. Now why couldn't it have been like this when I was here? It figures.
In the greedy 90's, some of which we are surely now paying for with the current economic meltdown, I remember there were hardly any parking spaces open on campus. The classrooms often numbered just under 100 students, most of them with 100 thousand dollar plus loans on tap, and Sid built another massive parking lot to hold the overflow. Then it too was often full of cars. I don't know what all the hype was about. It was like everybody thought they found the Golden Goose. Boy did we get scammed!
Soon, I'd had enough........On my way back to my rusty old car I stood on the long bridge between the classroom buildings and the gym. It was warm. I took a deep breath. It smells the same here. For a few seconds I was young again. My friends were there, my girlfriend, my dog. We were new, young, beautiful, full of optimism, idealistic. We were believers. The world really was good. Our hopes were high and had no limits. The future was wide open. The future was ours. The world, was ours.
Well, it's that time of year again, the wonderful holidays when I have to avoid the relatives due to the embarrassment involved in showing up in my ten year-old car, or having to explain why I can't afford a plane flight to visit this year.
This is great so far, watching the dog-ass Jets get walloped by Dallas again in my little tract rental house, with the neighbor's driving bass music thumping in through the cheap walls of this dump - a constant reminder that we're not living in the better part of town. It would be funny if it was only for a year or two, and I was younger, but this has been a constant condition for years since graduation from chiropractic college. Gosh, I wonder if maybe that was a bad decision?
Oh, wait a minute, they didn't mention the fact that it would be years before we could earn a decent living when we entered chiropractic school. Oh well..........my fault.
You can do better though. Take my advice and DON'T GO TO CHIROPRACTIC SCHOOL! Trust me on this.
Christmas should be interesting. I'll have to make that trip to Goodwill soon, I guess. I am getting pretty good at the bargain hunting thing.
Joined: Aug 2006 Gender: Female Posts: 363 Location: Illinois
Re: "I’m Screwed 4 Life" – Did you know that…? « Reply #22 on Dec 6, 2008, 9:37am »
If the relatives ask too many Qs & you are weary of answering, just tell them to read this site. It saves time & you can talk about fun things, like football! Sometimes if I have some contact, usually on the internet, I tell them if they want to know more about me, to read a certain board on a certain site. It gives plenty of info about my big topic of interest & personal things thrown in. It's so much faster than explaining. Happy Holidays! At least you won't be in front of Wal-Mart trying to scam the masses.
- New DC's (doctors of chiropractic) four year survival rate in practice, 20%
- Percent of that 20% that are profitable, 39%
- Current average rent, 1,000 square feet of office space: $4,000 to $6,000/month
source: recent chiropractic publication
Right now I know of at least five (5) fellow chiropractors who are unable to live comfortably and support their families with their chiropractic license. Having graduated between seven and ten years ago, two have not been able to obtain even one decent cash offer for their struggling practices, and [b]three have balanced between keeping their practices open, and taking occasional temporary work in other offices, or in unrelated fields to stay afloat. One is a confirmed "Mister Mom", with his wife basically supporting his practice. Add the student loan burden, and you have a formula for desperation.
To get a crystal clear idea of what is currently going on in the chiropractic profession, just compare opportunities between a medical doctor - opportunities site, and a chiropractic - opportunites site. Here they are; Chiroweb, and Wisconsin Medical Society.
First, notice, in Chiroweb, employment opportunities, practices wanted, practices for sale – 63(as of today, subject to change, of course).
Next, Wisconsin Medical Society, employment opportunities, practices wanted, practices for sale (under "For Sale/Lease") – 0.
I know it's a national site (Chiroweb) against a state site (Wisconsin), but it's good enough for this example. You can look up any other of the dozens of Medical employment sites to compare to. The point here is that the actual opportunities in chiropractic emphasize being ”self motivated, and enthusiastic”, whereas the opportunities in other health specialties emphasize ”education, and experience”.
What this means is that good doctors who paid attention in class in chiropractic are not valued, but average to bad doctors (and good ones, but it doesn't matter) who are self motivated and enthusiastic have great value. So, after ten years experience, you will have less value in this profession than a new graduate who is super enthusiastic. It doesn't matter what he knows about anything. As a result, experience and education have no value, and you can find yourself wasting years in a profession that is personality driven. I just want you, the future health care provider, to know this before plunking down your $120k plus.
So, there you are, health degree in hand, and your choices, in chiropractic, are:
- buy an existing practice for 100k and above - not knowing what you are getting into, work as an associate for some established chiropractor for one to five years which leads to who-knows where, or -open a practice right away, right down the street from all the other chiropractors and hope you make it.
Let's look at our opportunities in Chiropractic at this minute:
Quote:
Associate Opportunities, (Ohio) Motivated doctor with high professional ethics to be an associate in an existing office or a possible opportunity to have ownership in a new office.
Excuse me, were there any benefits involved here? That's mystery #1. Apparently, all you need to apply here is high professional ethics, which you obviously will have, because you will say so, right?
Quote:
(Colorado) Enthusiastic go-getter wanted! Opportunity to build your own practice in our 2,468 sq ft office, located right off I-70 in Denver. Close to the mountains in a growing area. Trained staff for billing and scheduling needs.
Okay, so they want an enthusiastic, go getter. Notice they didn't say anything about ’doctor skills’. What they are looking for, and what you need to be, to have a hope in hell of making it in chiropractic, is a salesman, not a doctor. Do yourself a favor, skip chiropractic school, and learn how to sell copiers, etc. There, you just saved yourself four years of agony. I just hope you're a smooth-talker.
Here's another:
Quote:
(PA) Seeking a self motivated associate in existing offices with potential for ownership. Experience preferred and adjunctive PA license needed.
Wow! So, let me see here, I gotta' be self-motivated. I guess my Chiropractic license proving at least four years of classroom and clinical work doesn't qualify me yet. I'd better tell them that I'm self motivated. Gee, I hope they believe me. They didn't say nuthin' about benefits, salary, bonus, or adavncement. I guess if I'm a good boy, after a couple of years, they'll let me buy the place, and then, maybe I can find some decent health insurance, and start paying the interest on my student loans. I'm gonna' call right now!
Alright, how about Chiropractic Practices for Sale: (Did I mention there were sixty three 63 practices for sale?)
Quote:
5 year all cash wealthy wellness base family practice collecting $256,842.00. Dr. take home before taxes $170,582.00. Will collect $286,000.00 for 2006. Open 4 days allowing long weekends. No HMO/PPO's. 92% cash. Low overhead. Dr. moving out of country.
Okay, so this doc's headed outta' here! I guess all that money was too much for him. That all sounds so great, I'm headed over there right now to fork over a couple a hundred grand. I hope they take checks.
Well, that's all for today sports fans. I hope that you, the health care providers of the future, have found this comparison enlightening.
IPFreely quoting Screwed4Life: "One is a confirmed "Mister Mom", with his wife basically supporting his practice."
Presto and I were discussing this type of situation recently in private discussion. I referred to it as a "Vanity Practice".
For those who are unfamiliar with Vanity Practices, here is a brief description:
1- Vanity Practices involve someone who has graduated with a licensed DC, but is not dependent on the career for income. A typical situation usually involves a woman (but there are men too, as the above example shows) who has a "bread winning" spouse. In this way, the practice is basically just a hobby/avocation.
2- The Vanity Practice DC usually rents a space at an existing DCs office, or maybe they agree to pay a percentage of their collections. They almost never maintain an independent office, since this would be a total waste of money/energy. This is a good situation for a DC with an existing practice because they can make money for essentially just occasionally letting the DVC (Doctor of Vanity Chiropractic) use an empty room or even just use the address.
3. Vanity Practices are a way for "saving face" for DVCs with wealthy spouses or families to maintain the illusion that they are pursuing the career/using their education, while not needing to do all the marketing/hustling that a real DC would need to put food on the table. DVCs usually only have a handful of patients, many of whom are friends or even relatives that they are treating for free or greatly discounted. By practicing, they still get to say they are a "doctor" if anyone asks what they do at the neighborhood cocktail party.
4. Vanity Practices ALWAYS have great websites, often promoting that the DVC does some obscure specialty technique (DVCs love technique seminars and continuing education since they have plenty of free time and all these seminars make them more "interesting").
Great chiro websites are often red flags -- especially if they have extensive self-congratulatory biographic info about the doctor -- since most financially successful practices I've seen don't maintain any website at all or keep it very minimum. Most regular DCs are too busy hustling patients to spend much time on a website. Also, ironically, regular DCs usually don't want to give a potential new patient TOO much info (such as technique specifics) to base a decision on; they just want to get 'em in the office ASAP.
5. When I commented that Vanity Practices are like a hobby, Presto responded that Vanity Practices definitely carry a lot more baggage than a real hobby. A lot of DVCs are probably subconsciously holding out hope that their vanity practice will eventually turn into a real career. Not only that, but they must continue to maintain the illusion even if the practice is essentially a waste of time.
6. It is possible to have a Vanity Practice without being rich. I saw a few people who did this. One girl I met had a 40 hour a week day job (doing something she could have done with just a high school diploma), but was using space at a local doc's clinic at night. She confided in me that she didn't have any patients (and this was after several years out of school), but had expensive business cards printed and a "practice name". It helped her maintain the illusion that she was still pursuing the career. In truth, it sounded like a boring way to spend nights and weekends, checking in at the office when she had no real patients. To me, this was an example of someone who couldn't admit to themselves that the career really didn't work out, and her self-identity was still based on being a DC.
The Bottom Line For Students (Why I Bothered To Write All This): Watch out for vanity practices, especially vanity practices that promote weird techniques. These docs will draw you into the profession, encourage you to become a DC, etc. Meanwhile, they are not really using chiropractic to pay their bills -- it's just a hobby for them, something to talk about with their friends. They will draw you into their game if necessary to maintain the illusion.
Being a DVC is not realistic unless you are independently wealthy or have a working spouse who can support this game. Even then, why be a parasite -- why not get a real career with enough customer demand to support your existence?
Watch out for slick websites and DCs who don't depend on their practice for income. It is my opinion that they are unrealistic when it comes to the real needs of new graduates -- often promoting very nonviable practice styles -- and a great source of bad career advice.
Re: "I’m Screwed 4 Life" – Did you know that…? « Reply #25 on Jan 10, 2009, 7:26pm »
IPFreely said: It doesn't matter what he knows about anything. As a result, experience and education have no value, and you can find yourself wasting years in a profession that is personality driven.
I remember the biggest practices, for a while, were ones started by kids right out of school. They, like me, were full of themselves that chiro could save the world. But reality soon sets in.
Re: "I’m Screwed 4 Life" – Did you know that…? « Reply #27 on Jan 27, 2010, 9:33pm »
Even in school, there were the "science" camps vs the "subfuxations" camp. The former believed or wanted to believe that there was science behind chiroquacktic as much as there is science behind everything else we do. The latter believed or wanted to believed that subfuxations were the cause of everything. EVERYTHING, including evolution, the war on terror, cancer, weight gain, depression, could somehow be related and blamed on the subfuxation.
Well, if Hitler received chiroquacktic care, his evil actions are the fault of the chiroquackter. If communist China received chiroquacktic care, we'd all be able to purchase an adjustment for $2, or $0.50 if you buy in bulk at the local KMart. If the terrorists received chiroquacktic care, we'd have found the WMD by now.
Yes, we are all screwed for life, fux you very much chiroquacktic.
Re: "I’m Screwed 4 Life" – Did you know that…? « Reply #28 on Feb 9, 2010, 11:51am »
Hey fellow chiros....are you dying out there..Ive been in practice for 15 years...I practice a musculoskeletal clinic with all the new age BS and 60+ visit treatment plans for all patients...I am watching the scientologist and scamming wackos getting rich as I continue to make less money every year....It really sucks out here!!!!
![[Home]](http://s2.images.proboards.com/menu/home.gif "[Home]")
![[New Topics]](http://s2.images.proboards.com/menu/topics.png "[New Topics]")
![[Help]](http://s2.images.proboards.com/menu/help.gif "[Help]")
![[Search]](http://s2.images.proboards.com/menu/search.gif "[Search]")
![[Login]](http://s2.images.proboards.com/menu/login.gif "[Login]")
![[Register]](http://s2.images.proboards.com/menu/register.gif "[Register]")
![[Live Chat]](http://s2.images.proboards.com/menu/chat.gif "[Live Chat]")
![[Search This Thread]](http://s2.images.proboards.com/search2.gif "[Search This Thread]")
![[Send Topic To Friend]](http://s2.images.proboards.com/buttons/sendtopic.gif "[Send Topic To Friend]")
![[Print]](http://s2.images.proboards.com/buttons/print.gif "[Print]")
Author
![[avatar]](http://www.itmimg.org/images/studies/debt.gif "[avatar]")
![[homepage]](http://www.floridaventureblog.com/uploaded_images/nobs.jpg "[homepage]")
Logged
![[avatar]](http://s2.images.proboards.com/avatars/greenhead.gif "[avatar]")
![[avatar]](http://star.pst.qub.ac.uk/users/dbj/Funnies/itchy.gif "[avatar]")
![[avatar]](http://animals.nationalgeographic.com/staticfiles/NGS/Shared/StaticFiles/animals/images/800/strawberry-poison-dart-frog.jpg "[avatar]")
![[homepage]](http://s2.images.proboards.com/buttons/www_sm.gif "[homepage]")