By Robert Braile, D.C.

One of the hottest topics lately has been the movement of Physical Therapists into the area of “Spinal Manipulation”. In Florida, as well as in many states, there is a well organized, well funded push toward expansion of the PT’s scope of practice into an area that many DCs see as an encroachment into chiropractic. Over recent years this fight has changed dynamics and we need to understand the big picture here if we want to address this issue.

First, we need to clearly understand that the PTs think that our opposition into spinal manipulation is extremely hypocritical as they see our profession as having long been completely stealing what they do. They have a good argument here as one trip into many chiropractic offices would raise the same question.

I do remember years ago hearing our chiropractic leaders use a rational that our use of “ancillary procedures” was different than physical therapy in that our intent was to use these procedures to assist the chiropractic adjustment. Today this argument does not hold water as most chiropractors are not using physical therapy in their office to assist them in correction of subluxations. One look at the submitted insurance claims completely eliminates that old argument.

So, clearly, we have encroached into their area. This eliminates using any argument that Chiropractors and Physical Therapists should remain separate in order to not confuse the public. In fact, they have ammunition in their argument that any chiropractic opposition to Physical Therapists broadening their scope into spinal manipulation should be ignored as we have clearly stolen what they do.

What has been a successful argument for us over the years has been that we perform our services with the level of expertise commensurate with a doctoral degree. We have always made the point that we are doctors, and that anyone with less training represented a danger to the public if they attempted “spinal manipulation” without the level of training we had in chiropractic spinal adjusting.

Unfortunately, this defense is quickly dissolving. First, PTs are initiating doctoral degrees and will soon graduate professionals that have the same level of education as us and are, also, primary portal of entry providers. Secondly, some of our schools offer less courses in “spinal manipulation” then they do, and some of our schools are not even identified as chiropractic schools anymore. This weakens our position while the Physical Therapists are continuing to strengthen theirs.

The arguments that we have successfully used for years are gone. The medical doctors, who have been unwitting allies to keep the Physical Therapists from being primary care givers, will also not have a reasonable argument as PTs get doctoral degrees. In fact, I believe that it is inevitable that Physical Therapists will become primary portal of entry providers and engage in extensive regimes of spinal manipulation. In fact, I predict that it will not be long before the MDs change sides on this issue and start a public relations campaign that says that Physical Therapists are safer and better trained than we are.

So what are we to do? It’s time we stop trying to stop others from doing “SPINAL MANIPULATION!” It’s time we start educating the public that what we do is not spinal manipulation and what we do is “specific scientific chiropractic adjustments.” It is also time we start educating the public that these adjustments are for correction of vertebral subluxations, and it is time to educate the public as to what subluxations are and what they can do.

The Physical Therapists are not going to start giving adjustments for the correction of vertebral subluxations anytime soon. To do so would require them and the medical establishment to acknowledge that vertebral subluxations do exist, they do affect proper function of the nervous system, and that correction of them does enhance health. In effect, they would have to say that they are practicing chiropractic, and this is something they collectively do not want to do.

In essence, our best, and last, defense is our core difference from the allopathic model. The procedure of spinal manipulation has never been unique to chiropractic. It is futile to try to stop others from doing it. However, our expertise is in correction of subluxations through specific “chiropractic adjustments” is exclusively ours. We are the only experts at subluxation correction. We are the only profession that adds this procedure to the vitalistic philosophy we embrace.

Ultimately, if we want to stop Physical Therapists from stealing chiropractic we need to recognize what we are, what makes us different, and then create a defense that protects that uniqueness, not a defense of common domain therapeutics such as “spinal manipulation”.