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Nature of the Work | Working Conditions | Employment | Training, Other Qualifications, and Advancement | Job Outlook | Earnings | Related Occupations | Sources of Additional Information
Chiropractors, also known as doctors of chiropractic or chiropractic physicians, diagnose and treat patients whose health problems are associated with the bodys muscular, nervous, and skeletal systems, especially the spine. Chiropractors believe interference with these systems impairs normal functions and lowers 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.
The chiropractic approach to health care is holistic, stressing the patients overall health and wellness. It recognizes that many factors affect health, including exercise, diet, rest, environment, and heredity. Chiropractors use natural, drugless, nonsurgical health treatments, and rely on the bodys inherent recuperative abilities. They also recommend lifestyle changesin eating, exercise, and sleeping habits, for exampleto their patients. When appropriate, chiropractors consult with and refer patients to other health practitioners.
Like other health practitioners, chiropractors follow a standard routine to secure the information needed for diagnosis and treatment. They take the patients 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 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 involvement of musculoskeletal structures, chiropractors manually adjust the spinal column. Many chiropractors use water, light, massage, ultrasound, electric, and heat therapy. They may also apply supports such as straps, tapes, and braces. Chiropractors counsel patients about wellness concepts such as nutrition, exercise, lifestyle changes, and stress management, but do not prescribe drugs or perform surgery.
Some chiropractors specialize in sports injuries, neurology, orthopedics, nutrition, internal disorders, or diagnostic imaging.
Many chiropractors are solo or group practitioners who also have the administrative responsibilities of running a practice. In larger offices, chiropractors delegate these tasks to office managers and chiropractic assistants. Chiropractors in private practice are responsible for developing a patient base, hiring employees, and keeping records.
Chiropractors work in clean, comfortable offices. The 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.
Chiropractors, like other health practitioners, are sometimes on their feet for long periods of time. Chiropractors who take x rays employ appropriate precautions against the dangers of repeated exposure to radiation.
Chiropractors held about 46,000 jobs in 1998. Most chiropractors are in solo practice, although some are in group practice or work for other chiropractors. A small number teach, conduct research at chiropractic institutions, or work in hospitals and clinics.
Many chiropractors are located in small communities. There are geographic imbalances in the distribution of chiropractors, in part because many establish practices close to chiropractic institutions.
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 only practice 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 educational, examination, and practice credentials meet State specifications.
Most State boards require at least 2 years of undergraduate education, and an increasing number require a 4-year bachelors degree. All boards require completion of a 4-year chiropractic college course at an accredited program 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 completion of a specified number of hours of continuing education each year. Continuing education programs are offered by accredited chiropractic programs and institutions, and chiropractic associations. Special councils within some chiropractic associations also offer programs leading to clinical specialty certification, called "diplomate" certification, in areas such as orthopedics, neurology, sports injuries, occupational and industrial health, nutrition, diagnostic imaging, thermography, and internal disorders.
In 1998, there were 16 chiropractic programs and institutions in the United States accredited by the Council on Chiropractic Education. All required applicants to have at least 60 semester hours of undergraduate study leading toward a bachelors degree, including courses in English, the social sciences or humanities, organic and inorganic chemistry, biology, physics, and psychology. Many applicants have a bachelors degree, which may eventually become the minimum entry requirement. Several chiropractic colleges offer prechiropractic study, as well as a bachelors degree program. Recognition of prechiropractic education offered by chiropractic colleges varies among the State boards.
During the first 2 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 2 years stress courses in manipulation and spinal adjustments, 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 (D.C.).
Chiropractic requires keen observation to detect physical abnormalities. It also takes considerable hand dexterity to perform adjustments, but not unusual strength or endurance. 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.
Newly licensed chiropractors can set up a new practice, purchase an established one, or enter into partnership with an established practitioner. They may also take a salaried position with an established chiropractor, a group practice, or a health care facility.
Job prospects are expected to be good for persons who enter the practice of chiropractic. Employment of chiropractors is expected to grow faster than the average for all occupations through the year 2008 as consumer demand for alternative medicine 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 back, neck, extremities, and other joint damage has become more accepted as a result of recent research and changing attitudes about alternative health care practices. The rapidly expanding older population, with their increased likelihood of mechanical and structural problems, will also increase demand.
Demand for chiropractic treatment is also 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.
In this occupation, replacement needs arise almost entirely from retirements. Chiropractors usually remain in the occupation until they retire; few transfer to other occupations. Establishing a new practice will be easiest in areas with a low concentration of chiropractors.
Median annual earnings of salaried chiropractors were $63,930 in 1998. The middle 50 percent earned between $36,820 and $110,820 a year.
Self-employed chiropractors usually earn more than salaried chiropractors. According to the American Chiropractic Association, average income for all chiropractors, including the self-employed, was about $86,500, after expenses, in 1997. In chiropractic, as in other types of independent practice, earnings are relatively low in the beginning, and increase as the practice grows. Earnings are also influenced by the characteristics and qualifications of the practitioner, and geographic location. Self-employed chiropractors must provide for their own health insurance and retirement.
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General information on chiropractic as a career is available from:
For a list of chiropractic programs and institutions, as well as general information on chiropractic education, contact:
For information on State education and licensure requirements, contact:
For information on requirements for admission to a specific chiropractic college, as well as scholarship and loan information, contact the admissions office of the individual college.
An industry employing chiropractors that appears in the 2000-01 Career Guide to Industries: Health services
Last Updated: March 30, 2000
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