Physical Therapists and the

Chiropractic Practice ActDenise Natale, D.C.Vermont Board of

Chiropractic

History

• March 2005– PT Advisor Board proposes

“housekeeping” changes to practice act, including adding mobilization

• April 2005– VCA responds with concerns

• July 2005– PT publishes draft language for

proposed act

History

• September 2005– PT responds to VCA April 2005 letter,

claiming qualifications

• November 2005– PT requests meeting with VT Board to

discuss definitions of manipulation, mobilization

• December 2005– PT and VT Board meet for fact-finding

History

• January 2006– PT’s invited back to

VT Board– PT’s respond with

letter

The Problems

• PT’s offer language from their Federation of State Board of Physical Therapy Model Practice Act

The Problems

• OPR/Legislator confusion– Both PT’s and DC’s offer their

version of the truth

• The PT language offers mobilization and manipulation as synonyms

The Problems

• No good universal definition of manipulation, mobilization seemed to exist– Many suggested definitions are

•Politically motivated•Old chiropractic dogma•Not reflective of current, unbiased

science•Not defensible in court

The Problems

• Compared to the extensive background work PT’s have conducted, DC’s are not prepared to defend their practice to legislators

The Problems

• To stay out of the “turf war” trap– This is not

about politics– This is a

public protection issue

The Problems

• We need resources!!!

Concerns Raised by Colleagues

• % of PT’s who currently perform manipulation– % of their patients receiving

manipulation

• PT’s ability to assess contraindications to manipulation

• DC’s ability to present a united front

Solutions

• Education– Define mobilization/ manipulation

– Safety record of DC’s vs. others

– Present to OPR, Board, Legislature prn

Resources

• FCLB• Becoming an expert

– Definitions– PT’s practice

• “medical” differential diagnosis vs.• PT diagnosis

– Risks and benefits of manipulation

When we circle the wagons this time, let’s not

shoot in!