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Chiropractors, also known as chiropractic doctors, diagnose and treat patients whose health problems are associated with the body's 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.
The chiropractic approach to health care is holistic, stressing the patient's overall well-being. 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 body's inherent recuperative abilities. They also recommend lifestyle changes-in eating, exercise, and sleeping habits, for example-to 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 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 emphasis on the spine and its proper function. Chiropractors also employ a postural and spinal analysis unique to chiropractic diagnosis.
In cases where difficulties can be traced to involvement of musculoskeletal structures, chiropractors manually manipulate or adjust the spinal column. Many chiropractors also use water, light, massage, ultrasound, electric, and heat therapy and may apply supports such as straps, tapes, and braces. They may also counsel patients about nutrition, exercise, 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.
Almost all 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 42 hours, although longer hours are not uncommon. Solo practitioners set their own hours, but may work evenings or weekends to accommodate patients.
Chiropractors who take x rays must take appropriate precautions against the dangers of repeated exposure to radiation.
Chiropractors held about 42,000 jobs in 1994. About 70 percent of active chiropractors are in solo practice. The remainder are in group practice or work for other chiropractors. A small number teach, conduct research at chiropractic colleges, or work in hospitals and HMO's.
Many chiropractors are located in small communities. There are geographic imbalances in the distribution of chiropractors, in part because many establish practices close to colleges of chiropractic.
All 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. Chiropractors can only practice in States where they are licensed. Some States have reciprocity agreements that permit chiropractors licensed in one State to obtain a license in another without further examination.
Most State licensing boards require completion of a 4-year chiropractic college course following at least 2 years of undergraduate education, although a few States require a bachelor's degree. All State boards recognize academic training in chiropractic colleges accredited by the Council on Chiropractic Education.
For licensure, most State boards recognize either all or part of the three-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 colleges 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, radiology, thermography, and internal disorders.
In 1994, 15 of the 17 chiropractic colleges in the United States were accredited by the Council on Chiropractic Education. All chiropractic colleges require applicants to have at least 2 years of undergraduate study, 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.
During the first 2 years, most chiropractic colleges 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 skeletal manipulation and spinal adjustments and provide clinical experience in physical and laboratory diagnosis, neurology, orthopedics, geriatrics, physiotherapy, and nutrition. Colleges 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 manipulations, 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 desirable 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.
Employment of chiropractors is expected to grow faster than the average for all occupations through the year 2005. Demand for chiropractic is related to the ability of patients to pay, either directly or through health insurance, and to public awareness of the profession, which is growing. The rapidly expanding older population, with their increased likelihood of mechanical and structural problems, will also increase demand.
In this occupation, replacement needs arise almost entirely from retirements. Chiropractors generally remain in the occupation until they retire; few transfer to other occupations.
In 1994, median income for chiropractors was about $75,000, after expenses, according to the American Chiropractic Association. In chiropractic, as in other types of independent practice, earnings are relatively low in the beginning, and increase as the practice grows. In 1994, the lowest 10 percent of chiropractors had median net incomes of $28,000 or less, and the highest 10 percent earned $150,000 or more. 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.
Chiropractors diagnose, treat, and work to prevent bodily disorders and injuries. So do physicians, dentists, optometrists, podiatrists, veterinarians, occupational therapists, and physical therapists.
General information on chiropractic as a career is available from:
American Chiropractic Association, 1701 Clarendon Blvd., Arlington, VA 22209.
International Chiropractors Association, 1110 North Glebe Rd., Suite 1000, Arlington, VA 22201.
World Chiropractic Alliance, 2950 N. Dobson Rd., Suite 1, Chandler, AZ 85224-1802.
For a list of chiropractic colleges, as well as general information on chiropractic as a career, contact:
Council on Chiropractic Education, 7975 North Hayden Rd., Suite A-210, Scottsdale, AZ 85258.
For information on State education and licensure requirements, contact:
Federation of Chiropractic Licensing Boards, 901 54th Ave., Suite 101, Greeley, CO 80634.
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.
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