Factual Counterpoints to Chiropractic Handout
1. “This is not an anti-competitive opposition. It is based on concern for public safety”
The NC licensing Board states that PTs performing spinal manipulation is safe and within a
PTs’ scope of practice and has had no consumer complaints in 20+ years
If there were public safety problems, we would have heard about them from the 47 other states
that do not have the physician referral restriction
If there were public safety problems, there would be reported incidents of harm at Ft. Bragg,
Camp LeJeune, and Seymore Johnson Air Force—right here in NC—and there are not
HPSO, the main PT insurance carrier, states that spinal manipulation shows no particular risk
Physicians do not oppose this bill
2. “Safety Concerns / Contraindications to spinal manipulation”
PTs have extensive education on full evaluation, screening, and examination to ensure that
they choose the appropriate patient who does not have any contraindications.
3. “World Health Organization common causes for complication from spinal manipulation: Lack of
skill, lack of knowledge, lack of rationale, attitude and technique”
PTs have the skill, knowledge, rationale, attitude and technique
PTs use evidence-based medicine, the same science-research-based methods that physicians
use to determine the best way to evaluate and treat neuro-musculoskeletal conditions
4. “Educational superiority of chiropractors”
PT education requires a bachelor’s degree with 10 science pre-reqs (full year of biology,
chemistry, physics, anatomy & physiology), and a 3-year clinical doctoral degree that includes
foundational sciences, and evidence-based evaluation, clinical reasoning, and treatment to
include spinal manipulation
There are 8 Doctoral PT schools in NC and 2 more developing programs; there are zero
chiropractic schools in NC
Most medical schools in the country have a Doctoral PT programs associated with them, but
no chiropractic schools.
UNC, ECU, Campbell, and Duke medical schools have Doctoral PT schools associated with
those medical programs. None of those medical programs have chiropractic schools.
5. Key Points
-“Physical therapists are not adequately trained or tested to read or diagnose from an xray.”
PTs are fully trained to evaluate patients to determine if they are safe and appropriate for
spinal manipulation; they know when an xray is required and will send a patient back to a
physician for the xray. PTs have full training on radiology.
-“PTs do not have the education, knowledge, skills to safely administer spinal manipulation.” If
that were the case, PTs wouldn’t do it in all the other jurisdictions and physicians would be opposed
to this bill and they are not.
-“No proven cost savings of having a PT provide spinal manipulation, so why put the public at
risk? 1) The public is NOT at risk; 2) Cost savings will occur when PT patients do not to need to take
the time to obtain a special referral.
6. “It’s not always about knowing how to manipulate the spine, but more importantly, it’s about
knowing when not to. . .” This is the one thing about the chiropractic opposition handout that is
PTs agree with.