I’m not sure why, but most people just assume that I have a personal vendetta against chiropractors being that I am a physical therapist. Anytime a chiropractor is mentioned in my presence, I get sympathetic looks and unrequested explanations as to why the visit occurred. It’s as if people think there are only a certain number of potential patients available and that DCs and PTs are all competing for their patronage. It’s just not the case! In reality, both disciplines are working toward the same goals of reducing pain and improving function for their patients. We have just gone about earning our license to do that in different ways. Let’s take a gander.
EDUCATION
- DC –
- 3-4 undergraduate years, 2-4 years Chiropractic school, 1 year residency = 5 years minimum
- 1-year internship that coincides with clinical courses while in training; NO residency required, rather optional
- Board Certification – National exam, Chiropractic Board at the State level and Diplomat specialty boards
- DPT –
- 3-4 undergraduate years, 3 years Doctor of Physical Therapy program = 6 years minimum
- Required to have a minimum of 30 weeks of full time internship; Residencies exist in all specialities, certified by: American Board of Physical Therapy Residency and Fellowship Education, but are optional
- Board Certification – Federation of State Boards of Physical Therapy (FSBPT) for all US states; Commission on Accreditation in Physical Therapy Education (CAPTE), a division of the US Department of Education that accredits the academic programs
STATUS
- DC – Doctor of Chiropractic – Not medical doctors, but are considered health care providers in some states
- DPT – Doctor of Physical Therapy – Not medical doctors, but are considered specialty practitioners
EXPERTISE
- DC –
- Evidence to support their expertise in the adjustment of the spine, with extension of their knowledge into the scope of PT, general medicine, radiology, and neurology; Do not prescribe medication (unless in New Mexico, where limited prescription rights now exist)
- Specialties – Orthopedics, Pediatrics, General Rehab, Internal Disorders, Radiology, Neurology, Nutrition, Occupational Health, Sports Medicine, Forensic Sciences
- DPT –
- Evidence to support their expertise in human movement and restoration of all movement related dysfunctions, with extension of their knowledge into the scope of chiropractic and general medicine; Military PTs also order diagnostic tests and have limited privileges to prescribe medication for neuromusculoskeletal dysfunctions
- Specialties – Orthopedics (generalist practice), Sports Medicine (Generalist & Sports related), Pediatrics, Geriatrics, Women’s Health, Neurology (SCI, TBI, MS, ALS, CP, Parkinson’s, etc.), Cardiovascular & Pulmonary (COPD, CHF, etc.), Clinical Electrophysiology, Oncology
PRACTICE
- DC –
- Private Practice Clinics generally
- Some are employed by health systems and hospitals and deal with general alignment restoration within the skeletal system
- DPT –
- Can be self-employed, Private Practice, Hospital-based, Skilled Nursing Facility, Traveling Company, Sports Teams, Inpatient Rehabs, Emergency Room, Contractors, Consultants
- Settings – Acute care, Inpatient/Outpatient Neurologic Rehab, General Outpatient, Orthopedic, Geriatrcis, Pediatrics, Veterans Affairs, Military, Sports Medicine, Women’s and Men’s Health, Wound Care, Work Rehab, Electrophysiology, etc.
TREATMENT TECHNIQUES
- DC – Chiropractic adjustment (grades I-V) ranging from soft tissue mobilization to joint adjustment, use of therapeutic modalities and exercise as an adjunct to spinal manipulation and massage
- DPT – All manual therapy techniques including joint and soft tissue mobilization, therapeutic modalities, neurologic rehabilitation, sports performance, gait training, muscle coordination and performance, wound care, massage, cardiovascular rehab, etc.
DIAGNOSIS
- DC – DCs diagnose joint subluxation complexes, and most medical conditions depending on state law. Treatment of many acute non spinal or traumatic conditions may require referral to the correct specialty practitioner.
- DPT – PTs diagnose movement, musculoskeletal, and functional related conditions within their scope of practice. Like DCs, they do not diagnose medical conditions, but have the education and training to recognize and refer to the correct practitioner.
All of the above information are facts taken from the following respective websites:
- American Chiropractic Association (ACA): www.acatoday.org
- American Physical Therapy Association (APTA): www.apta.org
With all that being outlined, I’d like to make a few personal comments that I believe to be true regardless of what healthcare practitioner you are in the market for (including physicians, surgeons, etc.)
- You need to be comfortable with whom you are entrusting your health. I suggest that you consult with the provider regarding your concerns before any final decisions are made. You need to be on the same page with the suggested treatment and have confidence in your provider’s ability to perform their job. If you do not feel comfortable and confident, BEAT FEET and find someone new.
- A PT is not a PT is not a PT. Though we have all completed the required educational components and have passed our exams, this does not mean that every PT knows how to do everything. Nor should they! The health and medical field is enormous and new evidence is revealed everyday towards or against treatment regimens. It is impossible for anyone to know everything. This being said, make sure you find the right therapist, with enough experience, to address YOUR needs. For example, do not go to a Pediatric Specialist with an ankle sprain on your 45 year old body. If a therapist primarily works on Acute Care, maybe don’t see them about your Sports-Related injury. More importantly, don’t waste your time or resources with an unenthusiastic, uninformed, and passive approach to your care. The same goes for any other healthcare practitioner.
- Often times, a multi-disciplinary approach could be just what you need. Perhaps your chiropractor can realign your spine, allowing you to tolerate that functional strengthening your physical therapist has in store for you. It doesn’t have to be one or the other. I’d argue that we can, and should all live and work harmoniously.
In conclusion, I do not have a problem with chiropractors, so don’t feel bad about speaking their names around me! I believe we all have our role and expertise in the health and wellness field, so potential clients should find the right fit for them. I never have a problem referring clients out if I believe they would benefit from another provider. After all, YOU and everything that is in YOUR best interest is my main concern.
Any and all thoughts or experiences you’d like to share are welcome!