While cervical disc pathology can unquestionably produce radiculopathy, many patients presenting with arm pain, paresthesia or perceived weakness do not exhibit the clinical behavior of true nerve-root compromise. In these cases, failure to differentiate the primary pain generator may lead to unnecessary spinal injections, nerve ablation procedures or surgical consultation despite limited likelihood of benefit.
Report from Down Under
First, may I say thank you to the many U.S. chiropractors that have offered kind hospitality. People that my wife and I had previously never met welcomed us as students when returning for postgraduate studies. Thank you for putting out the welcome mat!
Every practicing chiropractor in Australia shares denial-of-trading rights where most patients shop in the big "public health marketplace." The nation's entire chiropractic profession is contained in the private health marketplace.
The boycott of our profession from providing chiropractic care in public health care facilities is practically total. In my state, at least, private hospitals do not employ chiropractors. The future-planning program for our state public health services over the next 20 years does not even mention chiropractic.
The major public insurance, Medicare and Australia's Department of Defence reimburse medical manipulators, but not chiropractors. And in recent years, Australia's National Competition Policy, which requires equal competitiveness and the protection of consumers, has come into effect. Its fair application will greatly conflict with vested medical interests, and that will test the integrity of our parliaments.
For the first time the use in practice of the so called courtesy title "doctor" by chiropractors generally has been prohibited under Part 3, Div. 1, 18(1) of a new act. It specifically prohibits the general use of the title "doctor" by chiropractors in their practice in New South Wales. The reason given by the government in taking this position is outlined in the minister's speech:
"The title 'Dr.' is associated in the public mind with the comprehensive treatment available from medical practitioners. While chiropractors and osteopaths provide a unique and valuable service to their patients, they do not provide the comprehensive service that medical practitioners are able to offer."
Having said that, I recommend Australia as a great place to practice. Please feel welcome to contact me at michealr@global.net.com.au.
Michael McKibbin,DC