This has been an ongoing discussion in this country over the last few years. Despite what they sometimes tell the public physical therapists (PTs) know that chiropractic manipulation works, which is why they want to be allowed to do it. The most recent story about this came yesterday as PTs in Washington state have a bill submitted to their legislature that would give PTs the ability to perform spinal manipulation if it passes.
The primary problem with allowing PTs to adjust is one of public safety. In most studies conducted about manipulation the reports of injuries are disproportionately caused by non-chiropractors. To begin with not all physical therapy schools teach manipulation as part of their curriculum. Yet this bill would allow all PTs who graduate this year or later to adjust regardless of their education in the subject. Of those schools that do teach manipulation most of them include it in the form of a single integrated science course. Some offer it as a weekend seminar, and some offer a single dedicated course in adjusting. The best I found offered by a physical therapy school was about 100 hours of training in manipulation. (Please tell me if you find one with more.)
“…the WHO has established a minimum of 2,200 hours of additional training for any other regulated health care professional, whose scope of practice includes the controlled act of manipulation, and who wishes to become proficient in the assessment and diagnosis of neuromusculoskeletal conditions and the application of spinal manipulation to address those conditions.”
The full guide is here if you’d like to read it, but essentially, in order to practice manipulation safely the World Heatlh Organization (WHO) says that even fully trained medical professionals of other professions who want to utilize manipulation should have at least 1000 supervised clinical hours of training in that subject. No PT school offers that.
Among the reasons that the original article gives for allowing PTs to adjust is, “Washington is one of only two states (Arkansas is the other state) in the nation that prohibits physical therapists from performing this procedure.” This is false. Here in Utah, and about half of the other states PTs are strictly prohibited from performing spinal adjustments. Though they are allowed to do mobilization which is probably what they are refering to. Mobilization is limited by range of motion and velocity. It is not manipulation.
Utah is not immune from this issue. In years past PTs in Utah have attempted similar legislation and were unsuccessful, however this is a new year and a new legislature. For those of you in Washington please contact your legislator and let them know of your concern for public safety with this bill. If you are in Utah, know that the PTs are submitting new legislation this year. I don’t know what is in that legislation. We need to keep our eyes open. They have tried to get this before and they may try again.
Don’t get me wrong. I want people to be adjusted. I think that any person dealing with health care should be adjusting people, if they have the training to do it safely. But if they had the training they’d be chiropractors. -sigh-