Chiropractic is a system of treatment based on the principal that a person's health is determined largely by the nervous system, and that interference with this system impairs normal functions and lowers resistance to disease.
Chiropractors take patient histories, conduct physical examinations, and give treatment for illness and injury. Because of the emphasis on the spine and its position, most chiropractors use X-rays to help locate the source of patients' difficulties. Chiropractors treat patients primarily by manual manipulation (adjustments) of parts of the body, especially the spinal column. In addition to manipulation, chiropractors use water, light, massage, ultrasound, electric, and heat therapy. They also prescribe diet, supports, exercise and rest. Most State laws specify the types of supplementary treatment permitted in chiropractic. Chiropractors do not prescribe drugs or surgery.
Almost all chiropractors work in private offices that are clean and comfortable. The average workweek is about 40 hours, usually including some evening and weekend time to accommodate patients who work. Because most chiropractors are self-employed, they can set their own hours.
Chiropractors held about 37,500 jobs in 1990. About 70 percent of active chiropractors were in solo practice; a small remainder are in group practice or work for other chiropractors. A small number taught or conducted research at chiropractic colleges.
Chiropractors often locate in small communities-about half work in cities of 50,000 inhabitants or less. This imbalance in the distribution of chiropractors, in part because many of them establish their practices in areas close to colleges of chiropractic.
Training, Other Qualifications and Advancement
All 50 States and the District of Columbia regulate the practice of chiropractic and grant licenses to chiropractors who meet educational requirements and pass a State board examination. Many States have reciprocity agreements that permit chiropractors already licensed in another State to obtain a license without taking an examination.
The type of practice permitted (scope of practice) and the educational requirements for a license vary considerably from one State to another, but in general, State licensing boards require successful completion of a 4-year chiropractic course following 2 years of college. Thirty-eight State boards recognize only academic training in chiropractic colleges accredited by the Council on Chiropractic Education. Some States require specific college courses such as English, chemistry, biology, or physics. Several States require that chiropractors pass a basic science examination. The National Board of Chiropractic Examiners' test given to chiropractic students is accepted by 48 State boards in place of a State examination. To maintain licensure, 41 States require that chiropractors complete a specified number of hours of continuing education each year to remain current in the field.
In 1990, 9 of the 15 chiropractic colleges in the United States were fully accredited by the Council on Chiropractic Education; 5 others were recognized candidates working towards accreditation. All chiropractic colleges require applicants to have a minimum of 2 years of undergraduate study, including courses in English, the social sciences, chemistry, biology, physics, and mathematics.
Chiropractic colleges emphasize courses in manipulation and spinal adjustments. Most offer a broader curriculum, however, including subjects such as physiotherapy and nutrition. During the first 2 years, most chiropractic colleges emphasize classroom and laboratory work in subjects such as anatomy, physiology, and biochemistry, while the last 2 years stress clinical experience. Students completing chiropractic education earn the degree of Doctor of Chiropractic (D.C.)
Chiropractic requires keen observation to detect physical abnormalities and considerable hand dexterity but not unusual strength or endurance. Persons desiring to become chiropractors should be able to work independently and handle responsibility. The ability to work with detail is important. Sympathy and understanding are desirable qualities for dealing effectively with patients. Newly licensed chiropractors usually seek to setup up a new practice, purchase an established one, or enter into partnership with an established practitioner. Because of the financial investment necessary to open and equip an office, some take salaried positions with established chiropractors to acquire the experience and the funds needed.
Demand for chiropractic is related to the ability of patients to pay for services, either directly or through health insurance, and to public acceptance of the profession, which appears to be growing. At present, newly graduated chiropractors are entering practice with little difficulty. However, the number of graduates from chiropractic colleges has increased fourfold since the early 1970's, and enrollments are expected to continue to grow. As more students graduate, new chiropractors may encounter competition establishing a practice in areas where other practitioners already are located.
In 1990, experienced chiropractors averaged about $66,575, after expenses, according to the American Chiropractic Association. In Chiropractic, as in other types of independent practice, earnings are relatively low in the beginning.
As in most other health professions, earnings are influenced by the characteristics and qualifications of the practitioner, the number of years in practice, and geographic location.
Self-employed chiropractors must provide for their own health insurance and retirement.
Chiropractors diagnose, treat, and work to prevent diseases, disorders, and injuries. They emphasize the importance of the nervous system for good health. Others whose professions require similar skills include acupuncturists, audiologists, dentists, naturophatic doctors, optometrists, osteopaths, podiatrists, speech pathologists, and veterinarians.
Sources of Additional Information
The board of licensing in each State capital can supply information on State license requirements for chiropractors. Information on license requirements and limitations on the scope of practice for all States is contained in The Directory available for $10.00 from:
Federation of Chiropractic Licensing Boards 501 East California Ave., Glendale, CA 91206
General information on chiropractic as a career is available from:
American Chiropractic Association 1916 Wilson Blvd., Arlington, VA 22201
International Chiropractors Association 1901 L Street N.W., Washington, DC 20036
For a list of chiropractic colleges, as well as general information on chiropractic as a career, contact:
Council on Chiropractic Education 3209 Ingersoll Ave., Des Moines, IA 50312