client infomed consent for chiropratic care

Electronic medical records (EMRs) hold great promise for improving the practice of evidence based medicine by facilitating communication between members of the health care team. The most profound influence of EMRs may lie in their ability to encourage clients' involvement in their own pets care.

client infomed consent for chiropratic care

Postby malernee » Sat Oct 28, 2006 5:40 pm

Many MD's and FDA fraud investigators define quackery as the promotion of unproven medical care in the
market place.

The AMA lost a case brought by chiropractic in
which the AMA felt it was unethical for its member doctors to deal
professionally with chiropractors on that basis. . A federal judge, Susan
ruled chiropractic was a licensed practice and therefore the AMA was in
of Sherman anti-trust laws in restriction of trade, and therefore
illegal.That is about where the issue stands.

Incidentally, chiropractors are not doctors in the usual sense. Not only are
they not trained to use medications or surgery, and have never trained in a
hospital caring for the sick and the dying, but they are also practicing a
false century old theory of vertebral subluxations as the cause of disease,
is a hoax.That is the issue.

If you have a dog, cat, or horse, you may find yourself invited to have its
spine "adjusted." Before taking any such plunge, here's what you should know.

No part of chiropractic education deals with animals, and no part of
veterinary education deals with manipulative forms of physiotherapy. In most states,
the practice of chiropractic is, by definition, restricted to humans (a
definition supported by a 1998 decision of the appeals court of the state of
Michigan). Nevertheless, some chiropractors purport to be able to ply their trade
on animals [A, B} and some veterinarians [B].say that they can perform
chiropractic adjustments. One Wisconsin chiropractor, for example, says that
"Chiropractic care offers a natural, drug-free adjunct to . . . total health care"
and is suitable for cats, dogs, and horses with: back, neck, leg, or tail
pain; carpal tunnel syndrome; degenerative arthritis; disc problems; head tilt;
injuries resulting from slips, falls; TMJ problems, difficulty chewing; pain
syndromes; sciatic neuralgia; sudden changes in behavior or personality;
uneven muscle development; uneven pelvis or hips; weight loss due to pain; "a
look of apprehension or pain in the facial expression"; and various other
problems [1].

A few doctors hold both chiropractic and veterinary degrees. There also
appear to be many animal "chiropractors" who are neither veterinarian nor
chiropractor but assert that they have experience.

From a legal perspective, practicing on animals is restricted to
veterinarians in all states. Technically, chiropractors may work on animals under the
direct supervision of a veterinarian if the veterinarian feels that such
treatment is warranted. However, in doing so, the chiropractor is working as an
unlicensed veterinary technician. Under the same umbrella, a chiropractor might
also be able to draw blood or take x-rays of an animal if properly
supervised. Accordingly, anyone manipulating animals who is not a veterinarian or
working under direct veterinary supervision is likely to be breaking current laws.

The American Veterinary Chiropractic Association (AVCA) of Port Byron,
Illinois, "certifies" DVMs or DCs after 150 hours of coursework and also offers
"advanced" courses. The idea that 150 hours can provide a chiropractic or
veterinary education seems odd, and the Association does say that its
certification is just the beginning. As scanty as 150 hours may seem, one-day seminars
are offered on animal adjusting. What would the response be if members of the
veterinary profession started giving one-day clinics on human chiropractic?

Sadly, many of human chiropractic's unscientific aspects are being applied
to animals. For example, in a chapter in 1998 textbook intended for
veterinarians, AVCA founder Sharon Willoughby, DVM, DC, states:

Chiropractors identify subluxations of the spine during clinical
examinations and then proceed to correct these lesions by specifically adjusting the
involved segments. . . . An adjustment is a specific physical action designed to
reinforce the biomechanics of the verterbral column and indirectly influence
neurologic function. . . .

For the veterinarian who understands the elements of holistic practice and
the philosophy of chiropractic, every patient becomes a possible chiropractic
patient. Every examination should include a spinal examination, and every
treatment protocol should include an adjustment if necessary [2].

Some "veterinary chiropractic" advocates assert that spinal problems result
in problems with other organ systems. In the above-mentioned texbook,
"holistic veterinarian" Joyce C. Harmon, DVM, writes:

Many practitioners believe that the spine is not worth checking unless a
musculoskeletal problem is being examined; however, every cell in the body has a
nerve supply originating in the nervous system. The nervous system is
therefore important to the health of all organ systems, and a chiropractic
examination is advised for every patient. . . .

Chiropractic is an excellent way to build a veterinary practice because it
includes preventive care after the initial problem is solved [3].

Some organs and cells function independently of nerve supply; and there is
no reason to believe that spinal adjustment in humans does much besides
loosening tight spinal joints. But even if chiropractic's subluxation theories were
completely valid, it should be obvious from a mechanical standpoint that the
forces on the spine of an animal that walks on four limbs are quite
different from those of humans who walk on two. Thus, even if human chiropractic
theories were plausible, direct application to animals might not be warranted.
For example, since the vertebrae of horses are the size of the adult fist and
surrounded by muscle, tendon, and ligament layers several inches thick, it
seems reasonable to wonder whether equine vertebrae can actually be manipulated.

Of course, all of these concerns beg the question of whether "adjusting"
dogs, cats, or horses really works. No scientific studies show that chiropractic
adjustment does anything useful in any animal. It may be reasonable to
surmise that moving an animal's limbs around, massaging its muscles, or giving it
any sort of attention might be well-received by the animal, but there is no
evidence that such attention can improve health. Furthermore, no published
study has ever shown how a chiropractic-related problem can be diagnosed in
animals or how treatment success can be determined.

There are also potential dangers. Chiropractic manipulation in humans
usually entails short, thrusting movements applied at segments of the spine or at
specific joints. Horses have been injured by overly aggressive maneuvers
described as animal "chiropractic." Manipulating the spine of a dog with a
degenerative disk carries the risk of severe and permanent harm to the spinal cord.
No part of chiropractic theory suggests that mallets, hammers or boards --
devices that have made an appearance in the horse world -- should ever be used.
(Indeed, the chiropractic-veterinary group itself decries the use of such
devices.) Dramatic movements that stretch beyond the limits of normal range of
motion -- for example, the lifting of a horse's hind leg over its back -- are
potentially harmful. Nor should any animal be manipulated under
tranquilization or general anesthesia.

It's easy to see how owners who want to do the "best" for their pets could
be convinced by unscrupulous or naïve professionals that "people need adjusting
-- animals must, too!" The human-animal bond is strong. However, that bond
should not be abused under the guise of unproven "therapy." There is no
scientific evidence that any animal ailment is amenable to spinal manipulation.
The current state of affairs should be as embarrassing to chiropractors, at
least those that are ethical and/or science-minded, as it is to ethical and
science-minded veterinarians. Sadly, the animals stand mute.

1.Kaufman Chiropractic. Downloaded Jan 24, 1999. (States that referral from
a veterinarian is required.)
2. Willoughby S. Chiropractic care. In Schoen AM, Wynn SG. Alternative and
Complementary Veterinary Medicine: Principles and Practices. St. Louis: Mosby,
1998, pp 185-200.
3. Harmon JC. Incorporating holistic medicine into equine practice. In
Alternative and Complementary Veterinary Medicine: Principles and Practices. St.
Louis: Mosby, 1998, pp 631-647.

art malernee dvm
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