On the day that Dr. Robert Francis, the dean of chiropractic sciences at Texas Chiropractic College (TCC) offered me the opportunity to represent TCC in attending a seven-week rotation through the orthopedic surgery department, at the University of Texas Medical Center, I enthusiastically said yes. One of the ultimate reasons for choosing my chiropractic education at TCC was due to their unique program offering senior interns the opportunities to rotate through various orthopedic and neurosurgery departments, at the largest medical facility in the world. This meant seven weeks of long hours and intensive didactic clinical rounds, but I was willing to make the sacrifice in time and energy to participate in this chance of a lifetime opportunity not available to chiropractic students at other colleges.
The Texas Medical Center dwarfed any medical facility I had ever seen. Fortunately, Ed Fritsch D.C., was my guide for the first week. Dr. Fritsch had attended rotations in the orthopedic as well as neurosurgery departments and was able to give me a working knowledge of finding my way around.
Every day begins at 7 a.m., with conferences in which the attending physicians present select cases to the residents who are then quizzed on their interpretation of the x-rays, various orthopedic procedures, what the current literature says, etc. Conferences are followed by the attendance of surgery. Posted in the doctor's lounge is a daily surgery schedule listing the procedure and operating room number. After changing into scrubs I would enter the surgery of my choice and observe laminectomies, spinal fusions, arthroscopies, hip and knee joint replacements, fracture reductions, osteotomies, etc., just to name a few.
Following surgery is the time when clinics are held in which the pre and postoperative patients are examined. The formal clinics are divided into the titles of scoliosis, pediatrics, total joint replacement, spinal orthopedics, general orthopedics, foot orthopedics, sports medicine, and osteomyelitis. It was at these various clinics that I saw the examination of close to 1,000 thousand patients and their x-rays, CTs, MRIs, and case histories. On a first hand basis I interacted with pathologies most students only read about like Down's syndrome, cerebral palsy, genetic defects, cauda equina syndrome, vertebral fractures, severe scoliosis, grade-three ligamentous injuries, severe diabetes, etc. The attending physicians who comprise the teaching faculty are phenomenal. Their high level of skill and dedication is obvious. I especially thank Dr. Bruce Browner, the chief of the department, for his instrumental efforts in making the rotation program a reality. Dr. Browner's reputation as being at the top of his profession is well-earned and evident to anyone who has seen him work.
As the weeks passed I soon came to realize how well I had been educated at TCC. I knew well the physical, spinal and orthopedic testing procedures performed. In the areas in which chiropractic specializes I would say my training was, in fact, superior. I sincerely thank the countless doctors taking the extra time and effort to answer my questions and discuss the biodynamic concept of motion palpation in chiropractic.
The personal sacrifice, although significant, was most certainly worth the interactive multidisciplinary clinical experience. My drive and direction to be the best doctor of chiropractic I can be is magnified and enhanced by my interaction at the Texas Medical Center. The entire health care delivery system is increasingly coming to recognize chiropractic due to the efforts of TCC and its pioneering programs. By allowing senior year transfer students and the experience of hospital rotations, TCC is making it possible for students all over the U.S. to have the opportunity to be part of the leading edge of our profession. I thank my alma mater for their pioneering work in advancing the chiropractic profession.
Many relevant diagnostic signs are not performed deliberately by the examiner or by the patient at the examiner’s direction. They are observed as the patient reacts to their condition. Fortin’s finger sign, Minor’s sign, and Vanzetti’s sign are three examples of this principle.
On Feb. 1, 2024, two more legislators – John R. Carter (R-Texas) and Robert “Bob” Good (R-Va.) – co-sponsored the Chiropractic Medicare Coverage Modernization Act of 2023, bringing the co-sponsor total to 155, two more than the total achieved over the entire two-year congressional cycle in which identical legislation last appeared (2021-22).
While working at the Lovelace Medical Center in Albuquerque, N.M., one of the primary care physicians stated that imaging every patient prior to receiving chiropractic was not medically necessary. It was at that point I reconsidered the need for the imaging of every patient to avoid malpractice.
