Recently a question was asked as to whether the vertebral subluxation was a diagnosis. I think BJ showed great wisdom in avoiding the term “diagnosis” in describing a vertebral subluxation and instead using the term “analysis.” True diagnosis is a medical term and like the use of the word “treatment” as opposed to “adjustment,” it does not belong in the chiropractic lexicon. I do think it is more than just avoiding a medical term. Some in our profession would like it to be a medical term. They believe it would make us seem more respectable and acceptable. Frankly, I’m just as happy that the medical community does not acknowledge the vertebral subluxation as a medical condition. Then they do not expect me to address medical conditions. As a chiropractor, I am addressing chiropractic conditions of which there is only one: the vertebral subluxation
Diagnosis means to “know thoroughly.” The connotation is that the diagnostician has the ability to distinguish one disease from another, to know the difference between different medical conditions and to discern from which one the patient is suffering. That is what the medical doctor is claiming to have the expertise to do; that for which his training has prepared him.
Recently, I had the occasion to go to an ophthalmologist. He concluded that the symptoms I was experiencing were not caused by an eye condition. Even though he was an M.D. and had training in diagnosing medical conditions, he refused to render a judgment outside his area of expertise. If only we chiropractors had the intestinal fortitude to do that.
I am personally very happy to say I do not know what your medical problem is and you will have to go to a medical doctor if you want that information. The ophthalmologist would not only not render a judgment, he would not even suggest who I should go to other than my “family doctor” to render a diagnosis or get a referral. In other words, as an eye specialist, he would say it was not an eye problem but he would not venture a guess as to what was the cause of the problem or to whom I should go to find out, other than my family doctor who was supposedly qualified to refer me to the right person.
Joe, great points. I’ve never understood why a DC would feel the need to “diagnose” a medical condition. Does that mean that they would adjust…err, I mean manipulate the patient according to the disease and not adjust according to the spinal analysis?
Thanks Joe- As a student at Life U, we are taught that we are diagnosing subluxations whether we like it or not. I had not considered the term analysis, and think it is much better than trying to diagnose anything! Thanks for your guidance!
Love It!! Only one Chiropractic condition: Subluxation. I just Love It!!
Joe,
I think your text “Practice Management for the Straight Chiropractor” addresses this very issue.
I believe in the text you wrote about the risk associated with making referrals or recommendations for the pm and instead recommended providing options (do nothing, seeking family doctor opinion only, chiro only or a combination of chiro and medical care) then documenting THEIR choice.
Two questions:
1. Is pain always a medical condition?
2. What about referring to a chiropractor who treats pain, is there a case for making this referral or only to the family doctor? Are there inherent risks in this choice?
Don,
The best medical doctors of Mayo Clinic are accurate only 35% of the time with their diagnoses… which means that they have a WRONG diagnosis 2/3 of the time! How can a medical doctor treat someone with an INCORRECT diagnosis? Look at their malpractice insurance premiums for validation. For the most part, these medical doctors have several Masters and PHds!!!! And YOU would refer to a “chiropractor” WHO chooses to treat pain and practice the medical objective? Does that really make sense to YOU?
Dr Lessard
Do you have a reference for the 35/100 accurency of theirs dianosis?
Thnk you
Don,
I have been using this information ALL the way from back in the day at Sherman College of CHIROPRACTIC. It was Joe Flesia WHO chose to teach the senior “diagnosis” class (last quarter) and it was a sub header called “Statistical Methods in Diagnostic Analysis” if I recall correctly. Perhaps Richie still has the notes, I sure don’t. 😉
BTW, whether Flesia was teaching philosophy, communication or even “diagnosis”, his methods were ALWAYS entertaining and NEVER boring. I owe “WARRIOR” big time! I’m committed to pass on many of his methods. 🙂
The text about 35/100 accuracy was for Yves! 😉
Claude I do not have the notes! LOL! but I remember the quote to be 28% w/ autopsy. Joe Flesia was a True Warrior & mentor. Had some really good philosophical talks w/him. The profession lost a great one.
Dr. Lessard,
I understand what you are saying. I asked this question this topic of referral to “chiropractors” (I’ll use your quotations for consistency) who are therapeutic in intent came up in Dr. Strauss’s text. There was mention of a new pm comes into an OSC office with the intention of using care to treat a symptom. After the history and the explanation of the non-therapeutic nature of care in the OSC office, the new PM was informed of the 4 options (do nothing, medical care only, chiro care only, combined medical and chiro care) available to the PM. If they insisted on having their symptoms treated the PM was asked if they would like the names of two or three local “chiropractors” that have that objective where they can seek this type of care.
This brought up my two questions:
1. Is pain always a medical condition?
2. What about referring to a chiropractor who treats pain, is there a case for making this referral or only to the family doctor? Are there inherent risks in this choice?
Don,
Where did you read that???
Dr. Lessard,
Case Management for Straight Chiropractors.
I’ll try to find the passage for you if I get a moment today.
Dr. Lessard,
Page 20 offer names of other chiropractors and Page 59 mentions symptoms are symptoms of a medical condition. Found in Case Management for the Straight Chiropractor.
An excellent text from Dr. Strauss!
Don,
Page 20 offer names of other chiropractors NOT for them to provide a medical diagnosis to the person. It is to offer the person two or three names of chiropractors WHO would choose to accept that person under that person’s terms. The point that was very well made, was that it is the chiropractor WHO, as a professional, is responsible for accepting a person in her practice. It is the chiropractor, WHO chooses to accept people under her terms and not theirs. –
– Page 59 mentioned “for medical problems”. Medical doctors are properly trained and qualified to practice the medical objective. Chiropractors are NOT trained to practice medicine or its objective. –
– In all fairness to Joseph, that is what I read.
Don,
I too always interpreted it to mean as Claude stated. I think it it was also meant to clarify that if the client is seeking a diagnosis, explanation to or guess of what is causing the pain/symptoms, that it isn’t the domain of the OSC’or (even IF it were from a VS), but rather medical practitioner.
If a NTOSC’or sent away people with pain or medical conditions, we’d see virtually no one.
… perhaps the author could clarify further what he meant when he wrote it 20 years ago. 😉
Dr. Lessard and Michael,
You are probably both right. I may have interpreted it incorrectly.