Regulated GROWTH? by Donald M. Petersen Jr., BS, HCD (hc), FICC(h)
The number of phone calls and emails we receive from new DCs is on the increase. Many are questioning why they can't seem to be able to make a living in their chosen profession. They graduate with high hopes, but also with the heavy burden of a substantial student loan debt, and are facing a very challenging health care marketplace. They contact us looking for answers to several questions. Here are some of the questions the leaders of our profession need to address:
• Is it time for the chiropractic profession to regulate the number of new DCs that enter the profession in the U.S.?
The medical profession has been doing this for as long as I can remember. Each medical school graduates so many MDs every year. By doing so, students must vigorously compete to matriculate into medical school. Imposing higher standards, of course, are based on the supposition that these high achievers will become outstanding doctors.
However in a report issued on October 8, 2001, Moody's Research noted: "We still believe that enrollment in chiropractic colleges across the country...has yet to stabilize and could decline further."
• Is this a policy our chiropractic colleges should consider?
How can we continue to survive when some DCs are willing to accept as little as $10 per visit?
Is there a level below which an adjustment should never be priced? In the business world, this kind of activity only serves to drive providers out of the market until the limited number of survivors can raise their prices back to an acceptable level. Is this what future graduates have to look forward to?
• Who will survive when new graduates are expected to work as associates for as little as $25,000 per year, while carrying $120,000 in student loans?
The "horror stories" we hear from associates are very disheartening. Some complain that the only doctors hiring associates are the "big hitters" that new graduates don't always feel comfortable working for. Others relate terrible working conditions and ask how this profession can expect to grow when we treat our associates so poorly. While hiring an associate is partly a business decision, there is also a responsibility to mentor and shepherd new DCs to help them further develop their skills.
• Are we forcing our new doctors to "expand their scopes" to survive?
Many graduates are adding acupuncture, homeopathy, physical therapy, and other modalities to their practices to provide more billable services. If these additional modalities fit into a doctor's health care philosophy, that's his or her decision. But if they're adding these just for the money, we may be encouraging the dilution of chiropractic through economic incentive.
(snip)
Donald M. Petersen Jr., BS, HCD (hc), FICC(h) Editor / Publisher of Dynamic Chiropractic Don@MPAmedia.com , www.chiroweb.com
I want to thank you for bringing up the plight of new doctors (See article, "Regulated Growth? Hard Questions that Need to be Faced,"). I graduated, at nearly 48 years old, in December of '98. I had dreamed of being a chiropractor for 25 years. Before enrolling in some "pre-rec" courses in '93 at Life U., I interviewed four doctors who'd been in practice at least 10 years, and all encouraged me to proceed. I spent the next five years, all my savings, and went over $100K in debt becoming a chiropractor. Now, at 50, I am barely eking out a living.
I worked two years illegally in my apartment, but I have a beautiful office now. My aged aunt gave me a 1987 Sunbird when I graduated, and I sold my old Grand Prix to buy my table. All my other equipment has been acquired a little at a time, and I own it, such as it is.
Of those four doctors who encouraged me to follow my dream, two sold out. One other is planning to do so next year. They are all, incidentally, terrific doctors. (The oldest is 51.) They don't like the competition, or the hassles with insurance companies. And they especially don't like the drop in income they've had pursuant to negotiated rate structures.
Since I had several other college degrees, I realized quickly that chiropractic school is not like other professional schools.
It's basically a trade school run by profit-motivated administrators. Each school is a discreet entity eyeing the others suspiciously as competition. The common good of the profession isn't an issue.
You are quite right about medical schools limiting their enrollment based on the number of MDs expected to leave the profession through retirement, death, or attrition each year. Did you know that this is done in every profession I can think of except chiropractic? As long as chiropractic schools operate from the mindset of proprietary trade schools, that will never change.
The trade-school mentality grew naturally out of our exclusion (some of it self-imposed) from traditional university settings.
We used the academic title "doctor" long before we were really academics. Many of our predecessors had very limited education, but a strong entrepreneurial spirit.
That can-do, make-a-buck way of looking at the world, coupled with rejection of and by the academic establishment, made for training arenas that looked more like beauty colleges than institutes of higher learning. The federal student loan programs made money available, and the exemplars cashing in on the high-dollar days of insurance parity brought in students in droves.
The balloon is deflating now, of course. The growth of the profession is being regulated – by harsh reality! Hundreds of new grads are waiting tables and tending bar, and mountainous student loans in deferment and on the Ford plan grow unrecognized as the bad debts that they really are. I could weep when I run into my classmates with sad eyes and strained smiles and none of the joie de vivre that used to characterize them.
I read in your publication that the year I started at Life, only a small percentage of people had PPO/HMO plans, but now it's the majority, by far. What a rude awakening it is to find out that no new doctors are being admitted to such plans except in remote areas. Thus, when a prospective patient looks in his plan coverage books for a chiropractor that takes his insurance, the only names to be found are doctors who've been in practice for years. Since this creates a protected market for established doctors, the powers in the profession are not about to do anything to push any willing provider legislation. And the new guys don't have the money, time, or experience to do it.
What's working for my classmates? The only classmates I know of who are doing well after these three years since graduation are those who ’had resources’. One guy had lots of credit cards; one gal had a wealthy granny backing and a mom willing to work for free; another had a big lump of cash from a 401K and a wife with a good job; and several had long established family practices to join. I only know of one person who was able to secure a bank loan for start-up money.
As in every aspect of life, money means choices when you become a DC. My classmates who had money were able to identify good places to practice and move there, buy screening equipment, market heavily, and hire consultants, in some cases. They had money to live on while they were getting off the ground.
All new DCs have the insurance problem and have to come up with ’creative’ approaches to handling the money issues, once they've finally gone out and lassoed some patients who haven't been choosing from a preferred provider list.
Unfortunately, every 'creative' approach I hear of seems to violate some law.For example: Monthly family plans constitute the practice of insurance without a license; pre-pay programs imply the promise of a cure. You can't charge a cash patient less than a PI or indemnity patient, because it constitutes a dual fee structure.
The solution? I don't think there is a fix for our new graduate troubles except for natural attrition and declining enrollment. The market always adjusts itself over time, even if the schools won't do their part.
The hellishness of it is that so many promising careers are never going to happen, and so many lives have been ruined by the broken dream and crushing debt, and so many years of earning power have been lost while people went to school instead.
I wonder how many suicides there have been (and will) be as a result. Lots, I expect.
A.M. Kosa, BA, MA, DC Alpharetta, Georgia
A warning to every prospective and current chiropractic student:
...and are facing a very challenging health care marketplace.
What does it matter what the "healthcare marketplace" is? Chiropractic is no more "health care" than Jiffy Lube is a restaurant - well heck, they have a snack machine, after all!
Chiropractic is a pyramid scheme, plain and simple. It's about the schools squeezing student loan money from students, practice management "gurus" squeezing money from practicing quacks, and practicing quacks squeezing money from auto and W/C insurers. What is with this farce pretending to be "health care"? Oh yeah, I forgot that's the cover story...
Quote:
Is it time for the chiropractic profession to regulate the number of new DCs that enter the profession in the U.S.?
"Chiropractic" can't regulate itself out of a paper bag. The schools run the show... oh, they'll get theirs soon enough when the student loan bubble crashes, but "chiropractic" can and will have nothing to do with it. As always, "chiropractic" will be simply wide-eyed bystanders... oooh, there's a light at the end of the tunnel!!! What's that whistling sound?
... blah blah blah various references to professional medicine deleted due to their hilarity in assuming that medicine and chiropractic are even slightly comparable blah blah ...
Quote:
However in a report issued on October 8, 2001, Moody's Research noted: "We still believe that enrollment in chiropractic colleges across the country...has yet to stabilize and could decline further
I wonder why? According to the (typically lying) genius pro-chiropractic posters here, everything is awesome! in chiropractic land.
Quote:
How can we continue to survive when some DCs are willing to accept as little as $10 per visit?
As if THAT'S the problem chiropractic faces...
Quote:
Is there a level below which an adjustment should never be priced? In the business world, this kind of activity only serves to drive providers out of the market until the limited number of survivors can raise their prices back to an acceptable level. Is this what future graduates have to look forward to?
I'm sorry I just can't go on. I can't believe how seriously these people take themselves. To think Don Petersen sat down and spent an hour of his life typing this garbage.
As if the world would even notice if "chiropractic" just disappeared tomorrow.
Re: NEW Warnings for perspective/current students « Reply #3 on May 27, 2008, 7:31pm »
Good one... I just noticed that article was written in 2001. That's hilarious...
7 years later, nothing has changed... except it just keeps gettin tougher every day... or stays the same, which in this case is pretty a meager existence.
Joined: May 2006 Gender: Male Posts: 2,202 Location: CA
Re: NEW Warnings for perspective/current students « Reply #4 on May 27, 2008, 11:37pm »
Quote:
The hellishness of it is that so many promising careers are never going to happen, and so many lives have been ruined by the broken dream and crushing debt, and so many years of earning power have been lost while people went to school instead.
When one considers this on top of all the quackery, it stands to reason that all the chiropractic "good guys"....aren't.
How can we continue to survive when some DCs are willing to accept as little as $10 per visit?
What an absolutely devastating article this is, IP, especially when you consider it was written by the editor of the profession's largest publication.
But, uh, yeah, Chirotalk is just making all this stuff up. There's no problems in the profession. We are all just, um, practice failures. Keep believing that.
If that article doesn't constitute "the writing on the wall" for anyone considering "$120,000" worth of student loans, I really don't know what does.
Hey, check this out: When I was going to Life University (back in the late '90's), the PRESIDENT of the International Chiropractor's Association was charging $10 an adjustment at his clinic.
Wonder what an adjustment is worth in Marietta, Georgia ten years later? A cup of coffee? A bag of corn nuts?
In your recent editorial "Regulated growth? (beginning of this thread) you ask: "Is it time for the chiropractic profession to regulate the number of new DCs that enter the profession in the U.S.?" and "Is this a policy our chiropractic colleges should consider?"
You offer medical school admissions as an example, suggesting that higher standards (and vigorous competition) enable medical schools to limit growth in the medical ranks.
To raise such questions is to address the economics of chiropractic schools in America. Since the basic formula for financing the training institutions was worked out by B.J. Palmer in the early years of the 20th century (Keating, 1997), relatively little has changed. Chiropractic colleges in the U.S. are heavily (80+%) tuition-dependent for their operating budgets, whereas U.S. allopathic schools rely upon tuition for some 5-15% of their annual operating expenses.
In the early days of the accreditation movement in the chiropractic profession, school leaders were adamant: "We cannot just give the profession the prestige and the advantages of the higher educational standard - we must ask them to become philanthropists and support it. It cannot be done on tuition fees alone" (Steinbach, 1944).
Indeed, when John Nugent,DC, NCA director of education, addressed the newly formed NCA Council on Education (forerunner of today's CCE) about the need to improve the facilities for basic science instruction, the quick response from Thure Peterson,DC, president of the council, was that it "could not be accomplished without proper endowment, because college income, based upon student tuition entirely, would not be able to defray the expenses associated with such a complete program" (Minutes, 1949).
Council leaders privately opined that "the lower one-third of the students in all chiropractic colleges represented the endowment for the upper two-thirds" (Minutes, 1955).
In other words, chiropractic schools were forced to take students they might have preferred to turn away in order to pay the bills.
So far as I can discern, the basics of financing chiropractic-training institutions in this country have not appreciably changed in the last 100 years. And with the recognition of the CCE by the federal government in 1974, the availability of guaranteed student loans has only increased the burden faced by an expanded number of chiropractic students.
(snip)
On the other hand, we're all aware of at least one chiropractic institution, which has spent its dollars to prevent the creation of a state-university-based (and funded) chiropractic college in Florida!
None of the American chiropractic colleges, so far as I know, is in a financial position to significantly increase the degree of selectivity it might otherwise like to exercise in admitting students. Accordingly, and rather unlike medical school recruitment, the only competition for admission to U.S. chiropractic colleges occurs among the admissions directors of the schools themselves.
Applicants who meet the minimum admissions requirements and can pay the hefty tuition charges will find a seat at some chiropractic college in this country. Even those schools which have upper limits for total enrollment are more likely to place an applicant on a waiting list than to turn her/him away. Nor will raising admission requirements alter the fundamental dynamic that drives this reality: chiropractic schools are supported by their students.
Poverty-stricken, tuition-driven finances are the bottom line, and consequently, our admissions departments encourage weak (albeit minimally qualified) individuals to apply. The bills have to be paid.
By way of contrast, the 125+ allopathic schools in America have the luxury of turning away the majority of applicants because they don't need the money. The medical profession can afford to limit its own ranks because medical education in this country is overwhelming paid for by the public through taxes.
So, the short answer to your question is that it seems very unlikely that U.S. chiropractic schools will be willing to "regulate the number of new DCs that enter the profession in the U.S."
Joined: Mar 2005 Gender: Male Posts: 532 Location: No B.S. Reality
Re: NEW Warnings for prospective/current students « Reply #7 on Jul 21, 2008, 3:42pm »
(Bill Esteb produces literature for the chiropractic profession. This is an e-mail from ‘Dr. Enough’ so he won’t receive Bill’s ‘Monday Morning Motivation’ e-mails. The e-mails are weekly ‘rah-rah, get pumped’ messages sent to anyone who subscribes.)
After 20 years in the chiropractic profession it is quite evident to me that it is dying. The people in my state organization are likened to the band on the TITANIC; they go to parties and meetings, drinking their fine brandy, wearing their best attire while the chiropractic ship slips slowly into the ocean of obscurity. The only way to squeak by a living in my state is to be a personal injury or workers compensation attorney’s bag man.
Nothing you can tell me will change the fact that the insurance companies are paying less than the price of a cup of Starbucks coffee and pastry, not to mention not letting me do my job.
Re: NEW Warnings for prospective/current students « Reply #9 on Jul 26, 2008, 2:15pm »
Its been 12 years since I sold my practice and left Chiropractic.
I will remember the good times and patients, but I am angry that we were not told the truth about making it
I see that nothing has changed, in fact based on recent posts the situation is getting worse.
To those who are depressed hang in there. I changed careers and now make a decent living. This is without selling, without obsessing about 3rd part pay and with good benefits and time off top be with my family.
My heart and prayers goes out to all of those who are not fulfilled.
Thank you for your thoughtful words in your article, "Regulated Growth? Hard Questions that Need to be Faced"
I am a 1987 Palmer West graduate and valedictorian. I saw the "handwriting on the wall" some time ago. I was even more concerned when I went back to my alma mater about five years ago to guest lecture for the 4th quarter philosophy class. Two points hit me really hard that day: Not one person in the class chose to be a chiropractor because they felt a deep affinity with the underlying philosophy of D.D. Palmer; and many students said they would be coming out of school with well over $100,000 in student loans.
Joined: Mar 2005 Gender: Male Posts: 532 Location: No B.S. Reality
Re: NEW Warnings for prospective/current students « Reply #11 on Sept 30, 2008, 1:40pm »
For those of you considering chiropractic as a career you need to be aware of the devilish marketing methods the schools employ to heist your educational dollars.
Links to more in-depth information and proof are in red.
Chiropractic is a healthcare profession based on the principle that the body has an inherent striving to maintain and restore its own health. This fundamental approach to wellness mirrors a new and changing attitude toward health care. More people are seeking natural ways to cooperate with their bodies’ own abilities to cope, adapt, heal and thrive.
‘Chiropractic is based on the principle ?’ – (Click here)
Not ‘wellness’! This has been thoroughly de-bunked - (Here)
Quote:
Becoming a doctor of chiropractic can give you the lifestyle of your dreams, and the profession is growing.
There are two MAJOR lies here (mostly):
1. ‘Lifestyle of your dreams ?’ – Translated this says, ‘You will make enough money to bring your fantasies to fruition.’ That of course, is a lie, unless you can live out your ‘dreams’ on $30,000 per year!
2. ‘The profession is growing ?’ – Enrollment at the chiropractic colleges was down 34% four years ago! I can’t even imagine, now, in today’s economic climate, how far down enrollment has fallen and will continue to fall - Especially after a new administration takes root in the White House.
Also, how can ‘the profession be growing’ when there is so little trust:
Dead Last!
Quote:
According to the Occupational Outlook Handbook 2006-2007 Edition from the U.S. Department of Labor’s Bureau of Labor Statistics, chiropractic employment is expected to increase between 18 and 26 percent through the year 2014 as consumer demand for alternative health care grows.
I discussed my thoughts on using information provided by the Occupational Handbook and the Bureau of Labor Statistics over three years ago.
"The average income generated per year by a chiropractor provided to you by the Bureau of Labors Statistics, quite frankly…is wrong. They get their information from national chiropractic associations (ACA, ICA, WCA etc.) These associations must inflate the amount chiropractors earn so people exploring the possibility of becoming a DC won’t be turned off by how little they actually make. Thus, if they scare off tens of thousands of potential DC’s per year their eventual membership, down the line, will decline. Membership dues are the primary method these organizations pay their office expenses, staff, pay lobbyists, supply the top executives with fat bonuses and bottom line…make money…ultimately, like every business, to profit. In theory, it’s in their best interest to make sure the marketplace is flooded with chiropractors so they will, in turn, pay yearly membership dues. The majority of chiropractors don’t belong to national associations anyway so it’s a flawed theory."
Quote:
Chiropractic was rated number four of the top 25 best jobs for 2005, according to Fast Company magazine. The list was based on job growth (a career that is in high demand), salary potential, education level and room for innovation, and “relied heavily” on data from the Bureau of Labor Statistics and Salary.com.
Where do you think Fast Company “relied heavily” on information to form their opinion? The same place as Bureau of Labor Statistics: National chiropractic organizations (see above).
‘Education level’ ?? - (Click here) to read what Chiropractic and Osteopathy Journal think about that!
• ”Hardly a week passes without a patient commenting on my Palmer diploma with a statement such as, ‘Oh, I see you went to Palmer. I hear they are the oldest and the best.”
• “Overall, Palmer students consistently perform better than the national average on the National Board exams.”
Are they for real? LIES! Straight-up lies.
Also…If chiropractic is in such ‘high demand’ why has the school gone to such disgusting lows as to advertise a DC standing in front of an early model Lexus like a used car salesman? Why?
Do you want to be lumped together into the same 'class' as those unaccredited diploma mills that run non-stop commercials during the day like ITT Tech and Devry Institute?
Want more?
Your chiropractic credits DON’T/WON’T transfer to other accredited schools! The credits are equivalent to those mills - UNTRANSFERABLE!
You are ’screwed 4 life’ when/if you decide to leave the profession for good.
Oh...when you're on the way out be sure to pick up this book:
Your income potential as a chiropractor can be healthy, too.
This of course, is a BOLD FACE LIE (for most) and perhaps the deadliest lie of all. A number of people will become a chiropractor solely based the perceived entitlement mentality of becoming a ‘doctor’. Many will also become a chiropractor for the perceived ‘entitled’ benefits of excellent income as a 'doctor'. Would you be shocked if, in the end, you make approximately $14.40 per hour after graduation? Guess what? YOU WILL! That’s what a McDonalds shift manager earns.
Quote:
Go to the Bureau of Labor Statistics website for more information on chiropractic’s career potential. As a chiropractor and business owner set your own levels of achievement as well as the hours that you work.
Dr. Marty Nemko, PhD - a professional career counselor, not only says chiropractic is an overrated career but so is being an independent business owner. This is a HUGE negative double-whammy.
Here are the 13 most overrated careers for 2008, reported from his column in U.S. News & World Report:
Plus you have the ultimate satisfaction of helping people lead healthier lives.
You don’t need to get over $125,000 in debt and waste 4+ years of your life to ‘help people lead a healthier life’. You can become a certified personal trainer within 6 months for a mere fraction of the cost and without any ’Negative Brand Equity’.
You can also work at a health food store. This wouldn’t even require a high school diploma, while still ‘helping people lead a healthier lives’.
When you realize the enormity of what happens AFTER graduation - you will have a few choice words: (Click!)
Current or prospective chiropractic student: Consider yourself Warned!
synaptic Guest
Re: NEW Warnings for prospective/current students « Reply #12 on Sept 30, 2008, 9:03pm »
Very nice post, IPFreely.
The fact that Palmer is saying the chiropractic profession will grow 18-26% over the next few years tells me one thing: they expect there to be even MORE chiropractors in an already saturated profession. However, you are also right, that enrollment at chiropractic colleges has been decreasing. Seems kinda strange, doesn't it?
I would say it is true that being a chiropractor can give you the lifestyle of your dreams, IF you manage to become one of the top earners in the profession, AND your dream lifestyle includes working in the office until 7pm on weeknights and half the day on Saturdays. Yes, you can set your hours to whatever you like, but if you want to make any money you have to be available when most other people are not working. Plus, it may be a good idea to make sure your dream lifestyle includes chronic back and shoulder pain from all those years of sacrificing your own body for the good of the patient.
I still don't understand why chiropractic is a career in "high demand". Just WHO is demanding more chiropractors? Why are many chiropractic offices so empty most of the day if this is the case? You would think that if chiropractors are in such high demand, all they would have to do is put a sign up and people would coming flocking to their doors, and they wouldn't be advertising "weekends and same-day appointments".
I thought it was funny that Palmer would advertise "Overall, Palmer students consistently perform better than the national average on the National Board exams." I found some interesting information on their website:
Here is a summary of Davenport campus Palmer students' performance on National Boards, along with a comparison to the national average: http://www.palmer.edu/pcc_pdf/pcc_nbce.pdf Out of 20 exams administered over the past two years, Palmer only beat the national average 14 times. And what the heck happened with Part I in the Spring of 2008?? A 67% pass rate?! Slacking off in the Basic Sciences, are we? As sad as this might seem, we learn that the Davenport campus students are actually among the top students of the Palmer schools...
Palmer Florida students beat the national average a whopping 9 out of 20 times. http://www.palmer.edu/pccf_pdf/pccf_NBCE.pdf Perhaps they would have done better if it wasn't for that 64% on Part I (Spring 2007) and 62% on Part II (Spring 2008).
All together, the three Palmer schools outperform the national average 56% of the time. So much for consistency!
Finally, I just wanted to make a comment on Palmer recommending potential students to take a look at the BLS website. I imagine they do this to show that in 2005, the average salary of surveyed chiropractors was $104K. But then we see that suddenly, in 2006, the median (which is more representative of the whole) income is only $65K. Why the sudden drop? Perhaps it is because the 2006 figure represents "salaried chiropractors"--those who work as employees (associate doctors), I suppose? However, based on my experience I have only known a couple of associate docs who earned more than $45K, and one of them treated close to 200 patients a week. According to these stats, the upper 25% of salaried chiropractors makes more than $96K. This is absolutely unbelievable! However, on the other end of the spectrum, 25% of chiropractors apparently earn less than $45K. This is more credible, although I'm surprised it would only be 25%. Perhaps I've just been kept in the dark, but it seems to me that $45K would be more indicative of the average associate salary, not the lower end.
Re: NEW Warnings for prospective/current students « Reply #13 on Sept 30, 2008, 10:33pm »
Quote:
How can we continue to survive when some DCs are willing to accept as little as $10 per visit?
The following coupon appeared in a Utah newspaper in 1910. Perhaps some chirotalker might wish to print it up, cut it out and take it to a local chiropractor who will honor it. $10 is the same fee that was charged for this same service 100 years ago.
« Last Edit: Sept 30, 2008, 10:35pm by rulerboyz »
Re: NEW Warnings for prospective/current students « Reply #15 on Sept 30, 2008, 11:17pm »
Yes, $220 may sound good, yet along with the bold claims you would have been making about your services, came the chance of being fined or arrested for practicing medicine without a licence. The following example was a lighter infraction, a $125 fine related to advertising an unscientific claim. This was in 1904 dollars. Therefore, your $220 exam might have just landed you a $3000 fine. Also keep in mind that many of these pioneering chiropractors were barely a step above being homeless when they were hit with what amounted to $10,000 fines for practising Medicine without a licence.
Attention Chiropractic Students! by Screwed4Life (not IPFreely)
Attention potential chiropractic school enrollees, due to my experiences with chiropractic as a career, and many other's experiences as well, I would like to take this opportunity, and the sheer power of today's modern internet, to discourage you from enrolling in any chiropractic school in the United States. Trust me, it is a huge scam, designed to drain your student loans, and leave you in debt for years, if not forever! Let's get together as a group, especially you existing loan defaulters, and others who have wasted your time, and shut these schools down! Please be careful when choosing to go to any chiropractic school, and make sure that they are not a bunch of crooks, like those scammers were at Life! Nobody even warned us what was going on, and we ended up stuck in this diploma mill, and many of us are facing lives that have been ruined! Yes, we could have done anything with our precious student loan allowance, and we pissed it away at this dump!
Alternatively, we can deny these schools access to the student loan program, which they have abused. Let them bankroll the students. We'll see how many hundreds of chiropractors they crank out after they have no student loan program to rob. Now, as a result of market saturation, chiropractors have a hard time getting paid under many insurance plans, have lost credibility as health professionals, and patients place little dollar value on time spent with them in our offices!
If you really want to perform spinal manipulation, get your M.D. degree, and then get certified in manipulation through weekend seminars. Wait, I forgot.......most of these docs couldn't get into medical school with a gun! Anyways, those of you who aspire to earn a six figure income through the health field, become a massage therapist, instead of begging for 7% of the population that actually goes to chiropractors. Plus, you'll only spend six months in school, and a fraction of the student loans, so, even if it is a mistake, it won't be a four year mistake, like chiropractic! Or, better yet, get your plumbing degree. I guarantee you will have more fun at least, and probably make more cash. Actually enjoy your life, instead of the usual cultist rah! rah! crap that is the chiropractic career experience.
When it gets right down to it, chiropractic is a big sales job anyways. It helps some people, some it doesn't. It's all about getting the patient visits. Who has the best marketing program? Who has the best rapport? That's who will make money in chiropractic, not the best doctor! Why bother to go to chiropractic school, spending 4-5 years of your life, spending thousands of dollars, when you can just go into sales immediately, and spend that time getting better at sales? Sell anything. Actually, if you can sell anything, you can sell chiropractic, but why bother?
Problem is, most people aren't salesmen (or women). It's a gift, like any other talent. That's why this career is killing so many people's dreams. Students actually think they will be doctors when they graduate, but they aren't! School skims through the sciences and med-lite courses. Then we get some training in spinal manipulation/adjusting skills. Next thing you know, we're at the mall, begging for patients all weekend with our bent pens, while the M.D.'s, pharmaceutical salesmen, and insurance executives are on the golf course! Give me a break!
Don't believe me? Just research it yourself, on the internet. Look at the numbers; divorce/separation rate for chiropractic students 90% +, 5 year business failure rate 60% + (It's much higher screwed), student loan default rate-number one! Sure, you could probably make it, but why pick this very difficult business? State of the profession? Dire! Just ask anyone who has graduated within the last ten years. Give yourself at least ten years from the time you enter school until you are earning a comfortable living, if you last that long! Insurance companies are dropping benefits left and right! Now chiros are pushing spinal decompression. Do you need four years in class to stretch low backs? No! Trust me, pick another field! This profession is based on gimmicks and gadgets. I know you docs who graduated in the 70's and 80's made big bucks, but that was over by 1995, when Sid Williams murdered the profession with his open door policy over at Life College.
If I save just one soul from this road that I have had the bad fortune to take, it will be a good day. Don't do it students. Be smart! Let's close 'em down!
Re: NEW Warnings for prospective/current students « Reply #17 on Oct 25, 2008, 1:40pm »
Hello my name is Ms. Green I live in California and I am considering becoming a chiropractor. I am new here and find so many things disturbing on this forum. I have been considering becoming a chiropractor for the last year. I have a lot of questions about what chiropractors are allowed to do and what they are not allowed to do. What is a DC scope of practice consist of. I asked a Chiropractor this and he told me that a DC can basically do anything a MD can do except prescriptions and surgery. He also told me that many DC's perform breast exams and have the authority to diagnosis any disease. He also told me that chiropractors can perform prostate exams, ecg, pelvic exams, pap smears, lung function tests, school physicals, pre employment physicals, DOT physicals, drug testing, and can excuse patients from school or work and that DC's are full service primary care physicans. He also told me that a DC can order any diagnostic test, lab work and refer someone for a colonoscopy if needed. He told me that some chiropractors are internal medicine doctors and have broader scope that the average DC. I was considering becoming a MD but my older brother is one and the hours he works is crazy. My cousin in a acupuncturist and has helped so many people that medical doctors could not help. Especially cancer patients going through chemo. Many MD's refer patients to him and consider TCM/acupuncture doctors very respectful. I dont know how MD feel about DC's but I must have to admit that I am very impressed with what they can do. I want to be a holistic type of family doctor that has the ability to diagnosis like a MD but does not do prescriptions or surgery. It seem that DC have this ability esp the Internal Medicine Chriorpractic Doctors. I have heard that some DC do acupuncture also with 100 hours of training. I would not do this due to the fact that my cousin had to spend 4 years studing TCM and acupuncture and it still took him many years to become competent. I think that this should not be allowed for DC to do acupuncture as I have seen the enormous amount of complexity envolved int TCM. I was considering becoming an acupuncturist due to the respect that I see many get from the medical community. I am just really excited about DC route due to the enormous scope of practice I have been told they have. My friend visited the DC and told me that is was no diff that seeing a MD. He wants do perform a breast exam on the next visit for a full physical. He also told me to come in for a breast and pap smear exam. I am considering it do to my interest in becoming a DC. Could someone that is a DC please give me some unbiased advise about what I am considering. Also could you provide my information on what the total scope of practice is for chiropractors and how extensive is the clinical training for chiropractors with regards to pelvic breast and exams and other in depth clinical training with regards to ecg and physical diagnosis. Also how much do chiropractors make a year that practice internal medicine? Also how many chiropractors have hospital privelages to admit patients when they need to be in the hospital. How many DC's are practicing full scope? Also he told me that in New Mexico DC are now allowed to write presciptions. I am thinking of moving to CT, FL, or NM after I graduate and still considering the best Internal medicine based chiropractic medical school to attend. I look forward to feed back that is in depth with regards to my questions and what I have been told.
Joined: Mar 2005 Gender: Male Posts: 532 Location: No B.S. Reality
Re: NEW Warnings for prospective/current students « Reply #18 on Oct 25, 2008, 4:00pm »
Hello 'Ms. Green' and welcome to Chirotalk.
You said: “I live in California”, correct?
Well...It’s kinda’ funny…BUT…Pro-Boards ‘Security Verification’ (NOT ME!) has you transmitting from: (Non-California state removed for security reasons). Very strange, don't you think?
Why would they say this? Did they make a mistake? Would you say they have their facts misplaced?
I hope you aren’t a troll, phishing for an argument.
If I'm mistaken please don't hold it against me. You see, we have to be on top of the MANY trolls who cause mischief in this forum. My intent is not to offend you but...you must admit it does make one very curious.
Re: NEW Warnings for prospective/current students « Reply #19 on Oct 25, 2008, 4:21pm »
To IPFreely
I guess I am in the wrong place to get feedback? I must be in a forum for detectives or secret agents? How dare you question where I live. For your information I do live in CA and I am in FL visiting my family. I also visit other states where my family is. But I dont think that is anyones business. What gives you the right to look at where I send a email from. That is an invasion of privacy dont you think, I must have not told you about my 2nd brother who is also a DA. I was just looking for some honest answers to my questions I have from what I thought was a honest website on chiropractic. Instead I end up with a person who claims to be a doctor but instead is a stalker? I am very offended that you would do such a thing and also post my personal information. I think that there are laws regarding these things esp to protect women. I have been stalked before and do not intend to go through it again. Now if you dont have any advise to give me then please do not respond to my post. Maybe I should just talk to my own family of doctors for there opinions on what I have been thinking of doing. Is everyone here as mean spirited and reckless with personal info as you? I can see now that you must not even be a doctor as the doctors that I know (my family) would never act like this.
Could someone that is a DC please give me some unbiased advise about what I am considering.
Ms. Green,
You have asked several questions, and I'll do my best to address as many of them that I can in an unbiased manner.
Scope of practice: depends on the state. The most liberal state I have encountered is Oregon, which allows DCs to prescribe over-the-counter medications if they choose, or to deliver babies (if you take additional post-graduate courses), or to perform minor surgeries (also, if you take additional post-graduate courses). Most states, however, limit the DC to performing chiropractic adjustments, x-rays, physical modalities (e.g., electric muscle stimulation or rehabilitative exercises), providing nutritional supplements, and other miscellaneous non-medical therapies. Some states are very conservative, like Michigan, which (I believe) only allows the chiropractor to adjust the spine and to take spinal x-rays.
I do not believe New Mexico allows chiropractors to prescribe medications. If it does, it's probably just referring to over the counter meds. After all, chiropractors do not receive any training in pharmacology, and it would be very dangerous for any DC to prescribe anything with significant side effects.
It is true that chiropractors learn to perform breast exams, pelvic and prostate exams, etc., but their training is usually limited to watching a 10-minute video and spending half an hour practicing on plastic models. I have heard of some chiropractors performing these exams on real patients in their practices, but they are usually rare. The sentiment that most chiropractors and chiropractic students have is that these kinds of procedures should be left to those professionals who regularly perform them and are able to tell when something is wrong (in fact, most of my classmates planned on never even using their stethoscopes after graduating from school). Personally, I as a chiropractor would not do any of these exams because I'd be afraid I might miss a potential cancer. Even if I found something abnormal, I'd probably recommend the patient go see their physician to be sure.
I'm not sure what you mean by "full service primary care physicians". Yes, DCs are primary care providers (meaning you don't need a referral to see one, unless your insurance dictates otherwise), but what is full service? DCs cannot prescribe meds, so if you needed any you'd have to go see another doctor.
I never have heard of Internal Medicine chiropractors. Whatever it is, I'm sure it's nothing like the MD/DO internists. If you want to be a holistic internal medicine doctor, why not be a DO? Osteopathic physicians share all the same rights and responsibilities that allopathic (MD) physicians do--they can prescribe drugs and perform surgeries--but they can also do manipulations (and they typically get the patient better in fewer visits than chiropractors do). Also, many DOs can help patients with problems that MDs can't.
Some MDs like chiropractors, but many do not. Even DOs sometimes have negative views about chiropractic, and they are more holistically-minded. I have never met a chiropractor who has "hospital privileges". In fact, most chiropractors are anti-medicine and would rather not associate with the medical community.
I would recommend "the best Internal medicine based chiropractic medical school" to you if I knew where it was, but in reality, there is no such thing. Honestly, if you would like to have the freedom to prescribe medications when needed, and be a holistic doctor who evaluates the whole body and would like to receive training on musckuloskeletal manipulation, I think you would be a good candidate for osteopathic medical school. Check it out.
Re: NEW Warnings for prospective/current students « Reply #21 on Oct 25, 2008, 10:21pm »
Thank you synaptic
I appreciate you taking the time out to help someone and give them guidance. I learned very early in my life that a desire to help people in need and the ability to actually do it, is not only the right thing to do but is required by people who aspire to become a doctor. I myself graduated from UF when I was only 22. I have done all types of work since then from modeling to giving a helping hand to people who are terminally ill. I could not believe what the last reply from that person who accused me of being a troll or a phinishing what ever they are or what they mean I have no idea. I have been considering attending in CA or FL for DC training. My family being in both is a real nice perk for me. I here that Palmer is in FL but I don't know how good they are or if they give good training with regards to primary care (the type I am looking for) I have a 3.8 gpa overall but need to finish a few pre reqs in Chemistry. I did some research today of my own and the internal medicine DC is a 300 hour course after graduation and you become a DC internist. I wonder if that changes the scope of practice for DC. I also visited today the NM chiro association and if you click legislation part you will see that they did recently pass the prescriptive rights for DC but require DC to take pharmo coures and other biomed course but they will be able to prescibe some dangerous drugs types similar to Doctors of Oriental Medicine in NM but I do not think to the extent that DOM's in NM. I know from my brother who has friends in NM who are DOM's and practice side by side with MD providing primary care services and can presribe just like MD, they are required to get extensive training from MD instructors in order to qualify for this advanced status.
I also have a few question more on DC, with regards to diagnosis and ordering of tests if you could provide me the can do and don'ts for DC in these area I would be grateful. I am looking into DO rout also and considering the new school VISTA in Colorado.
Why is there so much anger from DC on this forum I just don't understand it. I consider it an honor for a person to be called doctor no matter what type, as long as they are truly helping people and making a diff in patients lives. I wonder if so many have forgot there hippocratic oath they took when they graduated. My brother is a MD and he loves his job but never has time to spend with family. I do not want this type of hours because I plan on having a family one day. I don't see this type of anger among acupuncturists, my cousin really loves his job and really help a lot of people with TCM that have chronic conditions that are not responding to conventional treatment. I have seen MD even go to him for treatment. The school he went to most of the instructors where MD put now focus on acupuncture and oriental medicine. I only hear praise from the MD I have spoken with about acupuncture and TCM.
I have never heard any MD put down DC? I do not understand these things. I am pretty confused as of now. I thought DC had more clinical training to perform the type of tests and treatments that I spoke of in my first post.
I am still upset about the first reponse from that person. Pretty scary to get a response like that. I get the feeling that is because I am a woman. (I cannot stand egotistic males like that). I still have not idea what a troll is.
As for you synaptic I can see that you must be a very good doctor.
Why dont DC use a stethoscope? Even my cousin uses a stethoscope to listen to the lungs of patients that visit with the complaint of coughing. Or the heart when he gets patients with palpitations. I know that the MD really appreciate it. In fact he was credited with saving a persons life who came to his clinic for coughing and fever. After listening to lungs and heart he called there PCP MD and sent them to the ER, in the end the person was diagnosised with advance pneumonia. The patient had not seen there PCP in over three months. The MD now refers more patients and has even let my cousin shadow with her. I know that acupuncturists can get advanced training to do physical examinations after grad, my cousin took a lot of extra course taught by MD to do exam and recognize red flags that need immediate MD consultation. I would think the same should be available for DC.
I am going to keep doing research and hope to hear more from others DC and you about DC route. I really wanted to do DC because I would be doing something diff that the rest of my family (competition). I am just dissappointed about the negativity so far.
Re: NEW Warnings for prospective/current students « Reply #22 on Oct 26, 2008, 12:27am »
green,
I encourage you to keep doing your research. You seem like a very smart person, and you must be if you managed to get a 3.8 GPA in college. If you decide to pursue the chiropractic route, I just hope you know exactly what you're getting into before jumping in.
You might be naive as I once was, thinking that the world of chiropractic is just wonderful. I would like to share a few things with you that I wish I knew before going into school:
Not everyone likes chiropractors. In fact, many consider chiropractors to be the "used car salesmen" of health care. It sounds degrading, but in reality, this is somewhat accurate, because chiropractors must be able to "sell" lots of visits to their patients. Not everyone who likes chiropractic can afford to see one. Part of the reason for this is that insurances don't have very good chiropractic benefits (if they provide them at all). Another reason is that chiropractic care often only provides temporary relief, requiring patients to make multiple visits to the clinic. Only about 1 in 10 people ever see a chiropractor. If you want to be financially successful, be prepared to run your own business. Most DCs are self-employed, because they can't earn very much working for someone else. Chiropractic incomes on average have gradually been declining over the past 20 years or so, while tuition has steadily increased over the same period. Chiropractors have the highest default rate on student loans compared to other health professions. More chiropractors default on student loans than all other health professionals combined. (Reference: http://www.defaulteddocs.dhhs.gov/discipline.asp) There exists a great divide within the profession of chiropractic. There are various schools of thought as to how we should advance the profession. On one extreme, there are schools like Palmer, Life, Cleveland, and Sherman, which are very philosophy-oriented and tend to be anti-medical and reluctantly teach diagnosis. On the other extreme are schools like Western States, National, and SCUHS, which many in the profession criticize for being "too medical". As far as a national organization is concerned, there are at least three that I know of (ICA, ACA, WCA), all of which are competing to be the "voice" of chiropractic. As a result, most chiropractors don't belong to any of them. Like me, you worked your butt off in undergrad trying to earn good grades. Perhaps you did this because you are considering medical school. I did it because I thought it would be just as tough to get into chiropractic school as it was for medical school. Turns out that many of my colleagues only completed 2 years of undergraduate work at a community college, some of them with a 2.5 GPA. If you go into chiropractic school expecting to be surrounded by intelligent minds, you will be disappointed. It is actually very easy to get accepted into chiropractic college. Adjusting patients all day everyday is physical labor. Many chiropractors end up quitting because of low back pain or shoulder pain, which they developed as a result of their work. At the crux of chiropractic is the vertebral subluxation causing nerve interference, something that still has not been scientifically proven. As far as scientific research goes, chiropractic has been found to relieve primarily musculoskeletal conditions, although conventional medicine seems to be just as effective. There is no evidence to support the view that chiropractic can help with various visceral ailments, although many chiropractors will swear that it does, based on the results of anecdotal cases.
It is true that some MDs/DOs work lots of hours, but I think much of that is either by choice or specialty-dependent. I have a friend who is a Family Medicine MD (a specialty which supposedly works lots of hours), and he works until 5pm Monday-Thursday and until 12 on Fridays, and Saturday mornings once every three weeks. I, on the other hand, worked until 7pm Monday-Friday and every Saturday until 1pm (but I had the mornings off on Tuesdays and Thursdays). Who do you think got to spend more time with their family, and who had more of a social life?
Some chiropractors choose not to use their stethoscopes or other medical equipment because they do not consider their usefulness to be valuable. They also feel that using such tools would make them look too much like a medical doctor, an image they would rather not have. You are right, however, that the chiropractor should be able to recognize red flags and refer to physicians when appropriate. I believe that most DCs are responsible enough to do that. However, I also know several DCs that I would never trust my health to.
I don't think becoming a chiropractic internist would really change your scope of practice. It may make you better at diagnosing disease, and it may be something you can advertise in the phone book, but it will not put you on equal ground with MDs and DOs. If you really have a desire to be an internist, I recommend the MD/DO route. It will give you a broader scope of practice, and you wouldn't have to put up with the lack of respect that chiropractors face.
Anyway, that's enough talk from me. If you decide to become a chiropractor, at least you now have a more realistic view of what you are getting into. Don't consider the negativity you've read so far to be a bad thing. You just might be grateful for it later on. Whatever you choose to do, make an informed decision, and good luck!
Joined: Aug 2006 Gender: Female Posts: 331 Location: Illinois
Re: NEW Warnings for prospective/current students « Reply #23 on Oct 26, 2008, 8:58am »
Hi Green! After reading your posts & the answers, I think a good career for you might be PA(physicians assistant). You do care for patients, but usually are not having the long hours or stresses an MD would have. Realistically, there are too many chiros for the business available. A PA would make a nice middle ground & it is a growing field. This is a skeptical board. The biggest disagreeement I have with chiropracty is more the business & hype angle than the physical. I do think there is some merit, but very little. If one has small 'issues,' body mechanics & exercise can correct them. If one has big issues, like an injury from an accident, a PT can also correct that & prescribe therapy. Unlike most of the regulars on here, I see merit in some alternative medicine, but it is very individual for each person. For instance, herbs don't work too well with me, but they have helped other immensely. So, I certainly would not say they are bad because I don't use them too often. I have never had acupuncture, but it has helped others. With socialized medicine coming, I hope the gov't. won't forbid certain therapies. They don't have to pay for them, but they shouldn't forbid them. We should still have the freedom to choose. There will always be a market for various things, but they work differently for each person. Chiro did little for me except make me more concious of my posture, etc. I finally started using a backpack in my late 50s & try to use both parts of my body more evenly as well as exercise. Little things like that have helped. Anyway, I digressed.... But, I think you should investigate the career of a PA & let us know how things are going. Best wishes, Mrs "T"
Re: NEW Warnings for prospective/current students « Reply #24 on Oct 26, 2008, 8:16pm »
Thank you Synaptic and Mrs. T
I am very grateful for you both of your advise. I have to admit that I am really disappointed with what I see in Chiropractic. I think that it is very sad because I always looked at chiropractors like any doctor with very high respect. I really wish that the profession was more united and really focused on making it better for everyone. I have not spoken to my family much about my interests yet. I guess I would probally get the same responses. I just thought it would be really cool to go a diff route that them. Do you guys ever see the chiropractic profession changing in the near future? I think that it would really benefit your profession and most importantly patients. I can remember when my cousin started out as a acupuncturist and the negativity years back was everywhere. Then more MD started interest in it and the profession took off. I see a lot of evidence based and scientific based care with acupuncturists. MD really like this. Do you think the chiropractic professioin will do this? I think if the profession reached out to the MD then the future would be filled with unlimited opportunities.
PA route does seem appealing esp with the opportunity to help patients with terminal illness. I am going to keep all my options open and I will say that the advise from both of you has really helped me so far.
Joined: Mar 2004 Gender: Male Posts: 5,939 Location: USA
Re: NEW Warnings for prospective/current students « Reply #25 on Oct 26, 2008, 11:46pm »
"I really wish that the profession was more united and really focused on making it better for everyone."
We all do Ms. Green but unfortunately there is more profit to be made scamming patients with ineffective and unnecessary care than getting them well so the national organizations and schools focus on justifying their care plans rather doing anything constructive.
Re: NEW Warnings for prospective/current students « Reply #26 on Nov 25, 2008, 7:43pm »
I vaguely recall someone posting something about Physical Therapists are being taught HVLA. I was wondering if this is part of the curricula or if it was a CEU...that is, if this is occurring at all.
Re: NEW Warnings for prospective/current students « Reply #28 on Nov 27, 2008, 3:29pm »
Allen, do you or anyone else here question the inconsistency of the medical profession in this particular case? On the one hand, we have an institute run by PTs and presumably training a number of MDs and DOs in manipulation, including HVLA of the upper cervical region. On the other hand, we have a vocal group of MDs who decry this practice, but almost exclusively target the chiropractic profession with their criticisms.
I have my share of major qualms with chiropractic, but this particular argument -- the danger of a "chiropractic neck adjustment" -- seems conveniently selective in its application. The MDs and DOs haven't a leg to stand on if they are willing to condone it within their own ranks. And the potential rebuttal that MDs and DOs have better differential diagnostic/screening skills rings rather hollow, considering that those who criticize neck manipulation generally have an absolutist bent. They hold that cervical HVLA should not be done under any circumstance in light of the perceived dangers.
There is a lot of good information on this website, but we need to be as objective as possible. For the reasons stated above, I think the seminars promoted in the link by AJB greatly undermine one aspect of the case against chiropractic made herein.
Re: NEW Warnings for prospective/current students « Reply #29 on Nov 27, 2008, 5:46pm »
I doubt that Allen had the intention of endorsing said training for which he posted a link. As far as questioning the inconsistency of the Medical profession goes, you will find many different viewpoints within the Medical community. That also includes Medical Doctors who fully support, endorse or use a wide variety of Alternative Medical approaches. It would be too simplistic to assume that you ought to always find a unified Medical point of view for any given subject.
Therefore, standard disclaimer of patient risk still applies regardless of what type of Doctor will performing the upper cervical manipulation.
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Perhaps it is because the 2006 figure represents "salaried chiropractors"--those who work as employees (associate doctors), I suppose? However, based on my experience I have only known a couple of associate docs who earned more than $45K, and one of them treated close to 200 patients a week. According to these stats, the upper 25% of salaried chiropractors makes more than $96K. This is absolutely unbelievable! However, on the other end of the spectrum, 25% of chiropractors apparently earn less than $45K. This is more credible, although I'm surprised it would only be 25%. Perhaps I've just been kept in the dark, but it seems to me that $45K would be more indicative of the average associate salary, not the lower end.
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