...modalities were used when indicated rather than for monetary reasons? Recently, I had the pleasant opportunity to view a presentation of various modalities and their supposed use in the chiropractic profession. The presentation was superb. However few, if any, knew what was being taught. Over two and one-half hours of slides, overheads, and practical demonstration went by swiftly and by my own count, less than 10 questions were asked and most of those were by two "students."
Please allow me to ask you -- the profession -- some simple but fundamental questions:
- What is the difference between high volt and Russian current?
- What is the difference between interferential current, premodulated current, and tri-heterodyne interferential current?
- What is: Faradic current
Diadynamic current
Direct current
TENS
MENS and how are they used?
4. Can muscle be strengthened with electrotherapy? If so, what type of current should be used, and how?
5. How does the treatment approach differ in the patient with muscle involvement versus no muscle involvement?
6. What is the relationship between pulse width and pulse rate, and what widths and rates would be best to produce pain control in:
a) the chronic care patient?
b) the acute patient?
Of course, the list could go on and on. The point is, unless you can answer these questions you have no business using or charging for electrotherapeutic modalities.
In the May 8, 1992 issue of "DC", Don Petersen Jr. wrote the article "Smile! You're on Candid Computer." Read this column and take heed.
Insurance companies, workers' compensation, and government agencies are measuring chiropractic treatment against medical and physical therapy dollar for dollar. Indiscriminate use will show up very quickly. When questioned for a sound rationale, could you provide one? I hope so. Chiropractic does not need another insurance fraud expose on "60 Minutes" or an article as found in the April 1992 issue of American Health magazine.
I challenge you to take a good look at your own practice and ask:
A. Do I have a sound rationale? B. Do I have the education and up-to-date research data to back me up? C. Do I offer a sound, reasonable explanation of what is wrong with my patient?
I sincerely hope that this has been thought provoking and will cause you to commit yourself to honest chiropractic and the finest product for the public.
P.S.: The answer to questions 1 through 6 will be in the next "What If" column.
Keith Innes, D.C.
Scarborough, Ontario
Canada
