Chiropractors, also known as doctors of chiropractic or chiropractic physicians, diagnose and treat patients whose health problems are associated with the body’s muscular, nervous, and skeletal systems, especially the spine. Chiropractors believe that interference with these systems impairs the body’s normal functions and lowers its resistance to disease. They also hold that spinal or vertebral dysfunction alters many important body functions by affecting the nervous system and that skeletal imbalance through joint or articular dysfunction, especially in the spine, can cause pain.
How is a chiropractor different from a physician or doctor of osteopathic medicine? The chiropractic approach to healthcare is holistic, stressing the patient’s overall health and wellness. It recognizes that many factors affect health, including exercise, diet, rest, environment and heredity. Chiropractors provide natural, drugless, nonsurgical health treatments and rely on the body’s inherent recuperative abilities. They also recommend changes in lifestyle—in eating, exercise and sleeping habits, for example—to their patients. When appropriate, chiropractors consult with and refer patients to other health practitioners.
The Work: Like other health practitioners, chiropractors follow a standard routine to secure the information they need for diagnosis and treatment. They take the patient’s medical history, conduct physical, neurological, and orthopedic examinations, and may order laboratory tests. X-rays and other diagnostic images are important tools because of the chiropractor’s emphasis on the spine and its proper function. Chiropractors also employ a postural and spinal analysis common to chiropractic diagnosis.
In cases in which difficulties can be traced to the involvement of musculoskeletal structures, chiropractors manually adjust the spinal column. Some chiropractors use water, light, massage, ultrasound, electric and heat therapy. They also may apply supports such as straps, tapes, and braces. Chiropractors counsel patients about wellness concepts such as nutrition, exercise, changes in lifestyle and stress management, but do not prescribe drugs or perform surgery.
Chiropractic requires keen observation to detect physical abnormalities. It also takes considerable manual dexterity, but not unusual strength or endurance, to perform adjustments. Chiropractors should be able to work independently and handle responsibility. As in other health-related occupations, empathy, understanding and the desire to help others are good qualities for dealing effectively with patients.
The Work Setting: Chiropractors work in clean, comfortable offices. Their average workweek is about 40 hours, although longer hours are not uncommon. Solo practitioners set their own hours, but may work evenings or weekends to accommodate patients. Like other health practitioners, chiropractors are sometimes on their feet for long periods of time. Chiropractors who take X-rays must employ appropriate precautions against the dangers of repeated exposure to radiation.
Newly licensed chiropractors can set up a new practice, purchase an established one, or enter into partnership with an established practitioner. They also may take a salaried position with an established chiropractor, a group practice, or a healthcare facility.
Entry Into Field: All States and the District of Columbia regulate the practice of chiropractic and grant licenses to chiropractors who meet educational and examination requirements established by the state. Chiropractors can practice only in states where they are licensed. Some states have agreements permitting chiropractors licensed in one state to obtain a license in another without further examination, provided that their educational, examination and practice credentials meet state specifications.
Most state boards require at least two years of undergraduate education; an increasing number are requiring a 4-year bachelor’s degree. All boards require the completion of a 4-year program at an accredited chiropractic college leading to the Doctor of Chiropractic degree.
For licensure, most state boards recognize either all or part of the four-part test administered by the National Board of Chiropractic Examiners. State examinations may supplement the National Board tests, depending on state requirements.
To maintain licensure, almost all states require the completion of a specified number of hours of continuing education each year. Chiropractic associations and accredited chiropractic programs and institutions offer continuing education programs.
Education: During the first two years, most chiropractic programs emphasize classroom and laboratory work in basic science subjects such as anatomy, physiology, public health, microbiology, pathology and biochemistry. The last two years stress courses in manipulation and spinal adjustment and provide clinical experience in physical and laboratory diagnosis, neurology, orthopedics, geriatrics, physiotherapy and nutrition. Chiropractic programs and institutions grant the degree of Doctor of Chiropractic.
Undergraduate Preparation: In 2005, 15 chiropractic programs and two chiropractic institutions in the United States were accredited by the Council on Chiropractic Education. Applicants are required to have at least 90 semester hours of undergraduate study leading toward a bachelor’s degree, including courses in English, social sciences, humanities, organic and inorganic chemistry, biology, physics and psychology. Most applicants have a bachelor’s degree.
The Career: Average annual earnings of salaried chiropractors were $60,000 in 2004. The middle 50 percent earned between $47,000 and $118,000 a year.
The Job Outlook: Chiropractors held about 53,000 jobs in 2004. Employment of chiropractors is expected to grow faster than the average for all occupations through the year 2014 as consumer demand for alternative healthcare grows. Chiropractors emphasize the importance of healthy lifestyles and do not prescribe drugs or perform surgery. As a result, chiropractic care is appealing to many health-conscious Americans.
Chiropractic treatment of the back, neck, extremities and joints has become more accepted as a result of research and changing attitudes about alternative, noninvasive healthcare practices. The rapidly expanding older population, with its increased likelihood of mechanical and structural problems, also will increase demand for chiropractors.
Demand for chiropractic treatment also is related to the ability of patients to pay, either directly or through health insurance. Although more insurance plans now cover chiropractic services, the extent of such coverage varies among plans. Increasingly, chiropractors must educate communities about the benefits of chiropractic care in order to establish a successful practice.
Schools in the Region:
Georgia: Life University, College of Chiropractic
South Carolina: Sherman College of Straight Chiropractic