Key Facts About the Chiropractic Profession


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Chiropractic is a health care profession that focuses on disorders of the musculoskeletal system and the nervous system, and the effects of these disorders on general health. These disorders include, but are not limited to: back pain, neck pain, pain in the joints of the arms or legs, and headaches. Doctors of chiropractic (DCs) practice a conservative approach to health care that includes patient examination, diagnosis and treatment. DCs have broad diagnostic skills and are also trained to recommend therapeutic and rehabilitative exercises, as well as to provide nutritional, lifestyle and dietary counseling.

  • There are 77,000 chiropractors in the United States who are required to pass a series of four national board exams1  and be state licensed.2 Roughly another 3,000 chiropractors work in academic and management roles. 
  • There are approximately 10,000 chiropractic students3  in 18 nationally accredited, chiropractic doctoral graduate education programs4  across the United States with 2,500 chiropractors entering the workforce every year.
  • An estimated 40,000 chiropractic assistants (CAs)6  are in clinical7  and business management roles for chiropractic practices across the United States.
  • It is estimated that chiropractors treat more than 35 million Americans (adults and children) annually.8  
  • Chiropractors are educated in nationally accredited, four-year doctoral graduate school programs9  through a curriculum that includes a minimum of 4,200 hours of classroom, laboratory and clinical internship,10  with the average DC program equivalent in classroom hours to allopathic (MD) and osteopathic (DO) medical schools.11 
  • Chiropractors are designated as physician-level providers in the vast majority of states and federal Medicare program. The essential services provided by chiropractors are also available in federal health delivery systems, including those administered by Medicaid, the U.S. Departments of Veterans Affairs and Defense, Federal Employees Health Benefits Program, Federal Workers' Compensation, and all state workers' compensation programs.12 

Patient Satisfaction/Clinical Effectiveness

  • In 2017, the American College of Physicians released updated low back pain guidelines that recommend first using non-drug treatments, such as spinal manipulation, for acute and chronic low back pain.13
  • Similarly,  a study published in the Journal of the American Medical Association in 2017 supports the use of spinal manipulative therapy as a first line treatment for acute low back pain.14
  • 95% of past-year chiropractic users say it's effective, and 97% of past-year chiropractic users are likely to see a chiropractor if they have neck/back pain.8
  • In a consumer survey, chiropractic outperformed all other back pain treatments, including prescription medication, deep-tissue massage, yoga, pilates, and over-the-counter medication therapies.15
  • Chiropractors are the highest rated healthcare practitioner for low-back pain treatments above physical therapists (PTs), specialist physician/MD (i.e., neurosurgeons, neurologists, orthopaedic surgeons), and primary care physician/MD (i.e., family or internal medicine).16  
  • With prescription pain drug abuse now classified as an epidemic17  in the United States and the number of spinal fusions soaring 500% over the last decade,18  the essential services provided by chiropractors represent a primary care approach for the prevention, diagnosis and conservative management of back pain and spinal disorders that can often enable patients to reduce or avoid the need for these riskier treatments.
  • Chiropractors' collaborative, whole person-centered approach reflects the changing realities of health care delivery and fits well into Accountable Care Organization (ACO) and patient-centered, medical home (PCMH) models bringing greater clinical efficiency, patient satisfaction and cost savings.19 
  • In 2015, the Joint Commission, the organization that accredits more than 20,000 health care systems in the U.S. (including every major hospital), recognized the value of non-drug approaches by adding chiropractic to its pain management standard.20

References

[1]  National Board of Chiropractic Examiners (NBCE) www.NBCE.org. Accessed December 2013.

[2]  Federation of Chiropractic Licensing Boards (FCLB) www.FCLB.org Accessed December 2013.

[3]  Association of Chiropractic Colleges, www.acc.org. Accessed December 2013.

[4]  Council on Chiropractic Education (CCE) www.cce-usa.org is the agency certified by the U.S. Department of Education to accredit doctoral graduate school programs who offer Doctor of Chiropractic (D.C.) degree; Accessed December 2013.

[5]  Association of Chiropractic Colleges, www.acc.org. Accessed December 2013.

[6]  American Chiropractic Association (ACA) www.ACAtoday.org and Federation of Chiropractic Licensing Boards (FCLB) www.FCLB.org 2013.

[7]  Certified Chiropractic Clinical Assistant (CCCA) program.  Federation of Chiropractic Licensing Boards (FCLB), 2013.

[8] Gallup-Palmer College of Chiropractic Annual Report: Americans' Perceptions of Chiropractic. Gallup and Palmer College of Chiropractic. http://bit.ly/2jrr7TG

[9]  Council on Chiropractic Education (CCE) www.cce-usa.org 2013.

[10] Meeker, DC, MPH; Scott Haldeman, DC, PhD, MD; Chiropractic: A Profession at the Crossroads of Mainstream and Alternative Medicine. 2002; 136(3): 216-227. http://annals.org/article.aspx?articleid=474085

[11] Coulter, Adams, Coggan, Wilkes, Gonyea. A Comparative Study of Chiropractic and Medical Education. Alternative Therapy Health Medicine. 1998; 4:64-75.

[12] American Chiropractic Association (ACA), 2013. https://www.acatoday.org/pdf/physicianstatus.pdf

[13] Qaseem, A., Wilt, T. J., McLean, R. M., Forciea, M. A., & for the Clinical Guidelines Committee of the American College of Physicians. (2017). Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Annals of Internal Medicine, 166(7), 514. https://doi.org/10.7326/M16-2367 

[14] Paige, N. M., Miake-Lye, I. M., Booth, M. S., Beroes, J. M., Mardian, A. S., Dougherty, P., … Shekelle, P. G. (2017). Association of Spinal Manipulative Therapy With Clinical Benefit and Harm for Acute Low Back Pain: Systematic Review and Meta-analysis. JAMA, 317(14), 1451–1460. https://doi.org/10.1001/jama.2017.3086

[15] Consumer Reports Health Ratings Center. Back-Pain Treatments. ConsumerReports.org; July 2011.

[16] Consumer Reports Health Ratings Center. Relief for your aching back: What worked for our readers. ConsumerReports.org; March 2013.

[17] Unintentional Drug Poisoning in the United States. Centers for Disease Control and Prevention, 2010.  Prescription Drug Abuse. White House Office on National Drug Policy. Accessed November 2013.

[18] Whoriskey, Keating. Boom in spinal fusions questioned. Washington Post. Page 1. October 28, 2013; Rise in spinal fusion surgeries driven partly by financial incentives. Washington Post. November 13, 2013.

[19] Accountable Care Organizations Optimize Outcomes, Cost Savings and Patient Satisfaction with Chiropractic Care. Foundation for Chiropractic Progress. May 2013.

[20] Clarification of the Pain Management Standard. Joint Commission. https://www.jointcommission.org/assets/1/18/Clarification_of_the_Pain_Management__Standard.pdf