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22
22nd March 04:39
External User
Posts: 1
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From: john@RM_THISromdas.HIP.berkeley.edu (John Badanes)
Newsgroups: misc.health.alternative Subject: Re: CHIROPRACTIC DEGREE vs. MEDICAL DEGREE Date: 17 Jan 1998 22:29:47 GMT + One day on MHA: + MY FAMILY PHYSICIAN SAYS THAT CHIROPRACTIC SCHOOL IS A JOKE + AND THAT THOSE "QUACKS" HAVE NO BUSINESS IN THE HEALTH PROFESSION. One of my admonitions in SOME GUIDELINES ON CHOOSING A GOOD CHIROPRACTOR was to avoid one who in any way competitively suggests that `chiropractic' is better than medicine. It appears I should have said, "greater than or equal to" so as to include those who would argue the equivalence of a DC and MD as though they were both merely flavors of ice cream with essentially the same ingredients. While the impact of picking chocolate over vanilla on any given day is clearly harmless, I suggest that treating your chiropractor as an entry level physician when you have a complaint is a much more serious choice, and IMPO, would be inappropriate, since chiropractors are not qualified to be primary care providers. Please be clear. I'm not saying that certain procedures that may be done in some chiropractic offices are not occasionally useful for some musculoskeletal conditions. Nor am I saying that there aren't some chiropractors who are extremely bright, articulate, accomplished, and/or very talented. There are exceptions in EVERY profession. I am saying that, among other things, the training of chiropractors is inadequate to the task of diagnosing and treating most conditions for which people go to the doctor, and rare conditions which (rarely) underlie patients' entering complaints, but nonetheless do occur. Most chiropractors should not even be considered competent musculoskeletal doctors or back specialists since almost all their `clinical' training, including diagnosis and management, is dedicated to "finding and fixing the [Chiropractic] Subluxation," which I have said before constitutes a delusional medicine. I am writing this in response to a recent post which lists the basic and medical science courses that must be completed by chiropractors presented side-by-side some of the academic requirements of MDs. The suggestion, of course, is that because chiropractors have a similar education to MDs, they can be considered to be medically competent practitioners. While I certainly can understand the motivation of a given chiropractor or the profession promoting this pseudo-equivalent medical simulacrum by calling each other "Doctor," wearing white coats in school, and publishing these `comparisons' and claims, I wouldn't confuse this imagery with the enthusiasm of patients who "REALLY like their chiropractor," are sure that, "It works," or who "know lots of people who have benefited," when choosing a primary physician. But MOST of all, I wouldn't cite chiropractic education as a justification for my chiropractic proclivity and pyschoaesthetic. You see, the chiropractic profession is fundamentally conflicted about education. On the one hand, they come from, and often _prefer_ to be identified with a `Healer' tradition. On the other, they want to participate in the health care and insurance industry, and so are forced to rationalize their therapy in the eyes of the scientific community and account for their diagnoses and treatments in medical terms. And so, chiropractic's relationship to the medical model, like any educational requirement your heart's not-in, is handled poorly, is unsupported, often resented, and most frequently `put-up-with' by those students who have no real intent of ever applying the material professionally. ("Adjust the spine..and all is fine.") Many chiropractors, in fact, are anti-intellectual, believing that being educated gets-in-the-way of healing. This schizoid attitude toward the western heteropathic tradition crystallizes in the chiropractic students' clinic experience, which generally starts somewhere between midway and two-thirds-way through their `academic' curriculum. In the clinic, they must reconcile the basic and clinical sciences with their chiropractic philosophy and methodologies. It is, as I've mentioned before, a conflict between whether there really IS such a thing as pathology as defined by anatomic and physiologic abnormalities on the one hand, and a Conceptual Pathology (The Chiropractic Subluxation) based on the need for the chiropractor to sell themselves as The Solution to this "Pseudo-Problem," on the other. In other words, "tissue, becomes an issue." Notably, it was B.J. Palmer (the son of D.D., the `father' of The Chiropractic), who denied the existence of the cranial nerves (anatomy) because they didn't fit-in with his Subluxation Paradigm (Delusional Pathology). This kind of denial underlies chiropractic `education' and practice today. So-much for chiropractic anatomy and neurology :-| While I don't think you can get any deeper than fundamental differences (by definition), the posted comparison-list leaves out several important facts pertinent to evaluating its implied assertion, which is that you can rely on a chiropractor for diagnosis and treatment of things medical (from glaucoma to neck pain), since chiros, like MDs, have the same course-work in basic and clinical sciences. Leaving aside the naive assumption that the title of a course with the number of units applied to it indicates _anything_ about the organizational content of the curriculum (how the task of training an MD and DC is allocated) or the quality of the course-work, let me say a few things about what's NOT on the list. 1) Compared to getting into medical school, matriculating to chiropractic school is a breeze. Only two years of undergraduate pre-requisites are needed with passing grades in the required courses. Many chiropractors have taken their basic science pre-reqs at schools that offer special 6-weekend courses in each. There is no equivalent in `chiropractic' of the MCAT (Medical College Admissions Test), which considered alone is not a good predictor of what KIND of doctor you will be, but IS an indicator of a certain level of intellectual function (disturbingly absent in the chiropractic profession). I was accepted to a `good' chiropractic school with only a phone call since I already met the requirements and had the tuition money. I was the one to suggest that they actually meet me personally (like an interview) to make sure I wasn't a mass-murderer. A person's character and especially their intellectual interests and motivation are not carefully considered in the application process. Chiropractic schools are essentially trade schools, tuition dependent, and can not afford to be picky about `choosing' who's admitted. And _because_ the schools require the tuition to remain `open,' they also can't afford to LOSE anyone, who, even at a chiropractic school, is demonstrably stupid, incompetent, and/or dishonest. I think the quality of the entering student has some bearing on the ultimate product. I didn't see anything about this on the comparison list. 2) The faculty at chiropractic schools generally do not have real expertise in the areas they teach. Quite often, they are DCs who have done their best to put together a course in pathology or diagnosis, but have no experience (as a medical doctor) beyond the textbooks they used and the DCs who taught them. Basic sciences: My biochemistry and physics teacher maintained that you weighed less when you picked one foot off the ground and that there was no gravity on the moon. Microbiology: When asked about the size of a virus, the professor maintained it was "very small," but wasn't quite sure if it was bigger than an atom, or not. A fungus was defined as the `green stuff' that appears on cheese left too long in the refrigerator. Clinical sciences: The OBGYN course is currently taught by a DC who believes that new-borns need to be Adjusted to treat the neck trauma incurred at birth. I didn't see anything about this on the list when comparing the 'units' of basic and clinical sciences. 3) Being at clinic is like having a free ticket to "Ripley's, Believe It or Not." The atrocities that go on daily in the name of `The Chiropractic' are too many to enumerate: using non-medically diagnostic x-rays to locate the (conceptual) Chiropractic Subluxation; "Adjusting" the first cervical vertebra on a patient who has fainted (as an emergency measure); faculty DCs, who when asked to confirm an arrhythmia on a patient, telling a student not to worry about it (since the instructor has no idea what to listen for) and that `Thuh' Adjustment will take care of The Problem; and on.. and on. This kind of data is conspicuously absent from the comparison list. Chiropractic outpatient clinics, where the so-called `clinical' training takes place are not affiliated with any hospital. Students do NOT see the patients they've only read about, so that their clinical judgement and opinion about a rash, a bump, or even a pain is almost worthless. The faculty DCs are generally Adherents of a particular Chiropractic Technique and so frequently only know a portion of their already narrow chiropractic approach. For example, a teacher who practices NUCCA Technique only analyzes and treats `malpositions' of the first cervical vertebra. Any patient complaint is presumed to be a misalignment of the first cervical vertebra and is "corrected" with what's called a 'Triceps-Pull,' a robotically tense, slow and convoluted maneuver so byzantine in concept and application that, well, you'd have to "See it, to Believe it!" If a student spends their entire clinic life "mastering" such an irrelevant medicine, how does this speak to the issue of training for primary care, or even a back specialist? Where is this information represented on the comparison list? Finally, I am not aware of any required clinical internship or residency (as with MDs) for chiropractors above and beyond their relatively minor clinic exposure and the irrelevant clinical antics to which I referred earlier. Leaving out this three to five years training that most MDs undertake AFTER graduating four years of medical school is perhaps the most grotesque, but no less naive, misrepresentation of the lists comparing MD and DC medical educations. But there's a qualitative subtlety which may be missed if we only focus on this obvious quantitative difference. This relates to the relationship of the chiropractor and the MD _to_ the course-work that's listed. Remember, that the Vitalism that informs much of Chiropraxis both historically and hysterically, is virtually unrelated to scientific medicine. Hence, the medical and science courses that ARE listed for chiropractors represent little more than a theatrical prop, like the white jacket and stethoscope needed to "Play a doctor in real (insurance-reimbursable) life." Medical education, OTOH, represents the fundamental and basic underpinning of the diagnostic and therapeutic strategies and skills MDs will develop and apply throughout their practice career. Chiropractic students *STILL* argue about why they have to take all this "medical stuff" knowing very well how easy it is to trade-in the complexities of biochemistry, nerve trespass, and patient management for the more lucrative world of Body Chemistry, Nerve Interference, and Practice Management once they graduate. How could ANY of this be apparent by merely comparing the course-lists posted by Chiropractor White? An MD `starts-in' with his patient (see above) saying, "Chiropractic education is a joke," and Chiropractor White provides the punch-line with his empty MD/DC curricular "parity" (parody). Wild, huh? ;') From The Chiropractic Byzantium. John Badanes [TEO.] ------------------------------------------------ ------------------------------------------------ The best defense to logic is ignorance. |
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