Take a Stand Against SB381

| by Heidi Jannenga PT17 Comments

Heidi JannengaToday’s blog post comes from WebPT Co-Founder Heidi Jannenga, PT, MPT, ATC/L.

4/18/2013 UPDATE

Woohoo! On April 15, 2013, California’s Senate voted against SB381, the bill that would have prevented physical therapists from being able to provide manipulative care. This marks a huge victory for the physical therapists in California and for our industry as a whole. And that deserves some serious celebration. But, even though the bill did not pass, our work is far from over. The fact that this bill even made it to the Senate floor proves that people still do not fully understand the expertise of physical therapists. So we must increase our efforts to educate the public on the benefits of PT and why we are the musculoskeletal experts. When people—our peers, our patients, and our potential patients—think back (or knee, or pelvis, or foot...) pain, we need to ensure they absolutely think “physical therapy” as their solution. With that in mind, let’s turn this comment thread into a brainstorming session. What can we do to spread the word about the awesomeness that is PT?

Original Blog Post

Down with SB381! As PTs, we have been fighting this issue of performing joint manipulation or joint adjustment for many years and in many states. Now, this fight is rearing its ugly head again in California.

In 2011, the APTA issued a statement: “Spinal manipulation is not designated as being under the exclusive domain of any one specific profession or group of practitioners. Physical therapists, chiropractors, medical doctors, and osteopathic physicians are all educated and trained to employ manipulation within the scope of their respective licenses and in a manner that protects the public's health, safety, and welfare. It is inappropriate for one profession to attempt to ‘own’ a specific technique or dictate clinical practice through such legislation.”

Although a bit dispassionate for my taste, as a manual therapy certified therapist, I fully agree with the above statements. For over 70 years, physical therapists have received the necessary training to practice manual therapy, including spinal and joint manipulation. In fact, the literature supporting the use of manipulation by physical therapists dates back to 1925. Evidence-based medicine shows that spinal manipulation for a select group of patients with subacute low back and neck pain is beneficial and cost-effective—and it’s physical therapists who are performing this research.

Physical therapy is a medical profession. We’ve proven our abilities; it’s time we get respect. Stand up against SB381. Call or email Senator Yee to let him know your thoughts: (916) 651-4008; Senator.Yee@senate.ca.gov. Regardless of what state you live in, you should care about this issue and get involved. We need to fight this together as a community. Don’t let another state go down, limiting the practice of your fellow therapists.

Take a stand against CA SB381

Addition as of March 15, 2013, in response to comments: 

Perhaps you’ve forgotten that our ultimate goal—why we all chose our respective professions (or at least why I hope we all did)—is to help our patients have a better quality of life. We all have a place in healthcare—different philosophies, sure—but a place nonetheless because our patients are better as a result of our presence. So why are we having this fight to begin with? Why are we wasting our energy fighting against each other?

To those in support of SB381, you’re doing it wrong. Here’s what it boils down to:

  • Manual techniques like manipulation are effective—this proven technique improves patients’ lives (read: helps us each achieve the ultimate goal of all our professions).
  • Physical therapists and chiropractors are both fully trained to use this technique. It’s not a versus scenario.
  • It is not (nor has it ever been) appropriate for one healthcare specialty to claim “ownership” of a technique.

Stop defending (read: hiding behind) this legislation. Let’s all provide this service to our patients. We owe them that. Unless, you know, you’re afraid of a little competition.

To those against SB381, thank you for keeping up the fight. But let’s not minimize our efforts here by insulting and name-calling. It’s bigger than that and we’re better than that. Focus on the issues. Call or email Senator Yee to let him know your thoughts: (916) 651-4008 or Senator.Yee@senate.ca.gov—regardless of where you live. Don’t let another state go down, limiting the practice of your fellow therapists.

Reader Comments

yes a pt can manipulate but a chiropractor adjusts. outcome and intent totally different.patients will choose chiropractors for their adjustments.

Strongly disagree, whoever wants to practice Chiropractic adjustments, please attend Chiropractic College then pass boards, so that patients will be on a safe side.
I don't believe that PT's can diagnose and treat as well as Chiropractic doctors can!!!!!!!!!!!

In the end its about the patients, right. As a DC I have no problem with PT's doing mobs or "grade 5's" or manip's. More power too them. At least they are and not just throwing meds at a problem. Meds can be just as bad as chiro care that has no therapeutic end point. The US healthcare system could use and adjustment/manipulation for gods sake and if it is a PT or a Chiro at least that is diminishing the publics dependence on drugs. Really dependence of any kind is problematic. So you go PT's! There are millions of people who suffer everyday that could be helped by this technique so lets get "crackin" (sorry couldn't resist)

#chiros #idiots

chiros are the black magic witch doctors of healthcare. ya'll just searchin' for a client base and a place in the healthcare system

chiropractors are like black magic witch doctors

The initial comment is not ignorance. They're wanting to work together with PTs. The basis of their argument, which btw everyone here is named anonymous, is clearly stated in their comment. The amount of training/tutelage is mutually exclusive to a person's skill set. That's not to say that "joe who took 300 credit hours of paper airplane making" is awesome at making paper airplanes. He could be a complete idiot and not have the talent. But at the end of the day, chiros go to school to adjust and mobilize joints and PTs go to school to do rehab whether that's passive or active. The grey area shouldn't be an argument but flattery really on both parties that one another obviously knows that both (specific) manipulation and rehab get the best results and in a faster time. So quit arguing, it's childish and you have Doctorate degrees for Christ sake.

Chiros, and I'll say some and not all, want patients to keep coming as means of prevention. A good chiro weans the patient off the increased frequency to something like monthly or bimonthly. There are scheisters In chiro just like there are scheisters in every other profession. Chiros want people to keep coming because let's face it, our posture and body mechanics suck day to day. Would you rather prevent having a cold if you could? The same goes for back and joint injury. They restore motion to areas that lack it to equally distribute the loads displaced on the body on a day to day basis.

I find it amusing that a few short years ago chiropractors were called quacks, not real doctors, witch doctors, and accused of practicing medicine without a license. Not only did the profession survive, but thrived. Now everyone wants to do the same exact thing us "quacks" have been doing for years, and were being called out for protecting or "owning" the technique we have fought so hard for. I find it flattering all of the pt's want to perform adjustments, but taking one or two classes in school or over the weekend does not mean your qualified. I took an ob/gyn class in chiro school, doesn't mean I'm qualified to perform the same services they do. We all have a place at the healthcare table. The sooner we start working together and respecting each others strengths instead of our weaknesses, the better the healthcare system, and our patients will be.

I completely agree with you, and Pt's have to stop pretending that they know what they doing!!!!!! Grade 5 and adjustments just for Chiros. PT's deal with your manipulation and rehab, but don't try to get out of your scope of practice.

I believe physical therapist are completely capable of performing joint mobilization and manipulation, both peripherally and to the spine. Matter of fact, physical therapist routinely incorporate mobilization and manipulation in an inclusive plan of care with therapeutic exercise, neuromuscular re-education and at times modalities to provide their patients a complete treatment. Most focus on patient education and encourage individuals the be independent and responsible for their health and healing. PTs understand that joint manipulation is one tool, to be used when a physical examination warrants it. Not a big stick applied to each and every patient walking through the door. I'm from Michigan and most patient's who I have seen after chiropractic care tell stories of dependency and years of ongoing treatment without resolution and in some cases, even little short-term relief. When I start seeing chiropractors spending more time providing solutions for their patients, not just "I'll see you next week" treatment plans, maybe I will consider their opinion on what my eleven years of education and 25 years of experience allows me to do.

the first comment is ignorant

ok anonymous- what is your basis? because I'm guessing you are a chiropractor? :)

I earned my bachelor's degree and a 3 year doctorate in physical therapy. I received extensive orthopedic training, including spinal manipulation. As a DPT, I am more than qualified to provide this service as part of my scope of practice.

One last thing that you have to finish is Chiropractic school and pass boards, then you can truly say that you are qualified to do what Chiropractic doctors can.

I don't think PTs have enough training to practice specific spinal manipulations.

I agree with you whoever wants to learn Chiropractic adjustments and use grade 5 mobilization please attend Chiropractic school then pass boards.

???? don't be an a$$... pts absolutely can.

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