As you contemplate a career in chiropractic, you may be wondering about the benefits and drawbacks of this profession.

Here are some things to consider as you weigh the pros and cons:

ON THE DOWNSIDE

• You must be able to work independently. And you need to be able to juggle many projects at the same time.

In other words, you’ll need to have the characteristics of any small business owner. Starting a chiropractic practice, just like any other kind of business, involves dedication and hard work.

• You must have a supportive family and friends. You have have occasion to ask them to pitch in and help. One young chiropractor needed to ask family and friends to lend a hand to turn a former gas station in Iowa into a clinic. Without the joint effort of many people, she would have paid much more to build her office and begin in practice.

• You will need to sell your chiropractic services. Your audience will be many different kinds of people, so you’ll need to be able to make public presentations, relate to people, and be able to communicate your passion for chiropractic.

Some people will not listen to you; others will disagree; and still others may even be rude. As Bob Levoy stated in a (November 2004) Chiropractic Economics column, “3 unrealistic expectations in managing your practice,” “Accept that you have a limited ability to change people.”

If you are thick-skinned, you’ll need to develop a thicker skin or suffer.

• You will have to contend with the bad press. Chiropractic and chiropractors do not always get a “fair shake” from the popular press. Although chiropractors are no longer being jailed as they were as recently as the 1970s, chiropractic still is under fire. In Connecticut in 2005, for example, a billboard carried warnings about the purported danger of neck manipulations, and a court case in Canada has caused many in that country to question the efficacy and safety of chiropractic.

• You’ll need to hunt down start-up money. When you graduate from chiropractic college, you will likely have a large student loan debt, and then you will probably need to take out a business loan to start your practice.

Some banks will turn you down flat; others will string you along for months and then tell you they can’t help. You’ll need to be able to lower your expectations and keep going until you find a bank who will work with you.

• You will have a limited ability to collect money from your patients. Many chiropractors have “cash” practices (in which they collect money from the patient directly rather than from an insurance company), because many insurance companies and HMO organizations do not cover chiropractic care.

You also may be limited in the number of chiropractic visits you may charge to an insurance company or Medicare/Medicaid in a period of time. That restriction is changing, and Medicare and Medicaid are reviewing their coverage, but many chiropractors find their ability to get paid is limited to directly charging the patients for care.

ON THE PLUS SIDE

Before you get discouraged, however, look at all the positives about this profession. Of all the careers available in the health profession, chiropractic is a great choice.

Here are some benefits of chiropractic over other health care professions:

• Shorter training period. Although the learning time is long (over three years from the time you start in chiropractic college and when you attain your degree), and the study is rigorous, it doesn’t take as long as becoming a medical doctor or dentist. You may also need a bachelor’s degree, either before you start in chiropractic school or before you graduate, so check out state licensing requirements.

• Scope and focus are up to you. You can choose the scope and focus of your practice. For example, you may decide to add other natural healing methods such as acupuncture or nutritional supplementation to your practice portfolio, or you may decide that “straight” chiropractic provides you with enough satisfaction.

Be aware that your ability to practice different chiropractic techniques is in great measure dependent on the state in which you practice. Some states, such as Illinois, have a wide “scope of practice” that allows chiropractors broad latitude in the types of services they can perform.

Other states limit your scope to spinal adjustments.

Do your research by going to the Web site of the chiropractic licensing board in the state where you wish to practice.

• Regular work hours. With some exceptions, chiropractic is a “9 to 5” profession. Rarely will you get called out to treat someone at 2 a.m.

Once you have established your practice, you can set your hours and find a comfortable lifestyle without being a slave to a pager or being awakened at all hours of the night with medical emergencies. Certainly people may be in pain and in need of a chiropractor at odd hours, but in most cases you can count on reasonable hours of practice.

• Reasonable malpractice insurance rates. Your malpractice insurance is substantially lower than insurance for medical doctors. Some medical specialties (obstetricians, for example) spend tens of thousands of dollars on malpractice insurance; the “typical” chiropractor spends less than $5,000 a year on malpractice insurance.

• Painless licensing process. Like other health care professions, chiropractors are licensed, but the licensing process is relatively painless. The process includes a four-part examination that is taken during your time as a student. Then, most states require an additional jurisprudence or ethics examination, but usually students can become licensed within a six months after graduation.

• Help for those who have despaired. Finally, chiropractors get a lot of satisfaction with treating people who have given up on the medical system and are looking for a drug-free way to health and pain-free life. There’s no better feeling that providing people with hope and health.

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