Chiropractors, also known as doctors of chiropractic (DCs) or chiropractic physicians, provide care for the body’s muscular, nervous, and skeletal systems. While chiropractors differ in the specifics of their beliefs and treatment options, in general chiropractors believe that interference with these systems impairs normal function and lowers resistance to disease.

As stated in a recent article about the chiropractic profession (Meeker and Haldeman, 2002), “the core clinical action that all chiropractors agree upon is spinal manipulation” (termed “adjustment” by many chiropractors) to relieve this interference. Although many still think ‘chiropractic’ is synonymous with ‘spinal adjustment,’ this is only partially accurate; chiropractors can adjust all parts of the body, including hands, feet, arms, and legs. Some chiropractors practice various specialties, including sports injuries, pediatrics, and orthopedics.

The chiropractic approach to health is holistic, stressing the body’s inherent ability to heal itself. Chiropractors focus on natural, drugless, non-surgical treatments, and rely on the body’s inherent recuperative abilities.

Like other health professions, chiropractors practice according to standard protocols, including taking a patient’s medical history, including physical, neurological, and orthopedic examinations and x-rays of the spine and other areas of the body. Many chiropractors also provide counseling to patients on nutrition, exercise, lifestyle changes, and stress management, but they do not prescribe drugs or perform surgery.

The practice of chiropractic requires keen observation to detect physical abnormalities. It also takes considerable hand dexterity to perform manipulations, but not unusual strength or endurance.

Chiropractic as a technique is ancient, with reference to spinal manipulation being traced back to the time of Hippocrates and Galen, “and manual and manipulative procedures have been depicted in the art and writings of most ancient cultures.” (Meeker and Haldeman, 2002). Chiropractic as a specific healing art began in the late 1800s, with the first spinal adjustment being delivered by Daniel David Palmer in Davenport, Iowa, in 1895. From that beginning, D.D. Palmer, as he is generally known, created the chiropractic profession.

During its first century, the chiropractic professional found itself in a battle with the medical profession over the right to provide care to patients. Although some states began to license chiropractors in the early twentieth century (beginning with Minnesota in 1905), chiropractors were sent to jail as late as the 1970s for “practicing medicine without a license.” In a landmark Supreme Court case (Wilke vs. AMA in 1987), the AMA was found guilty of antitrust violations in its attempt to eliminate the chiropractic profession. Today, chiropractic has gained recognition through sustained promotion efforts.

Chiropractic is the largest profession in what has been termed a “complementary” or “alternative” healthcare system; over 50,000 chiropractors practice in the United States today, over 70 percent in single-person clinics. According to Meeker and Haldeman (2002), chiropractic services are offered in over 50 percent of health maintenance organizations (HMOs) and 75 percent of private insurance plans.

Chiropractic education is provided in the United States by private institutions, and throughout the world at government-sponsored universities and colleges. Most U.S. chiropractic colleges are accredited by the Council on Chiropractic Education, an agency certified by the U.S. Department of Education.

A chiropractic degree in the United States consists of, on average, 4,820 classroom and clinical hours, including courses in anatomy and physiology, public health, chiropractic diagnosis and technique, care for special populations, and practice management. Students spend, on average, two years in classes and labs and one year in a clinical setting. Many schools provide external clinical experiences, including externships and clinic abroad experiences during the final terms.

To gain admittance to a chiropractic college requires at least 90 credit hours of undergraduate education (one school requires a bachelor’s degree), a GPA of at least 2.50 (on a 4.0 scale), and specific pre-requisite courses.

In order to attain licensure in most states, chiropractors must pass several levels of examinations, including exams in the basic sciences and chiropractic sciences, and practical examinations. Chiropractors are regulated in the United States by state chiropractic boards, each of which has its own specific requirements.

SOURCES

• Meeker, W.C. and Haldeman, S. February 2002. Chiropractic: A Profession at the crossroads of mainstream and alternative medicine. Annals of Internal Medicine: 136:3.

• Chiropractors. U.S. Department of Labor, Bureau of Labor Statistics. Online at http://www.bls.gov/oco/ocos071.htm . Accessed 7/2006.

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