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Chiropractic is a health care profession focusing on the impact of various disorders of the musculoskeletal system and the nervous system. In practice, chiropractors most often see patients to address neuromusculoskeletal issues, including complaints such as back and neck pain, headaches and discomfort in the joint of the hands, feet, and limbs. The discipline is particularly concerned with the relationship between the body’s structures and proper physical functioning, using a number of treatment methods to improve patient outcomes. Chiropractors or Doctors of Chiropractic (DCs) rely on hands-on techniques to correct physical alignment, concentrating on the role played by the spine. In many cases, spinal adjustments are made in order to bring the body into balance,
- alleviating pain,
- correcting structural alignment concerns,
- reinforcing the body’s natural healing properties,
- and improving the overall function of bodily systems.
Before being certified and licensed to practice, candidates for the profession undergo extensive training, rivaling the educational standards met by Medical Doctors and Osteopaths. After earning a BS and completing an accredited chiropractic program, passing in-depth written and practical exams and meeting state licensure requirements are two final hurdles to practicing.
Understanding the Role of Complementary Health Care
According to the National Center for Complementary and Integrative Health, in the United States, chiropractic is widely seen as a complementary form of medicine, used alongside other medical disciplines to reinforce patient health. Although chiropractic treatment draws from various techniques, spinal manipulation represents the core treatment administered by chiropractic physicians. The hands-on spinal manipulation techniques used by practitioners address specific complaints, but the underlying philosophy shared by chiropractors is centered in the belief that aligning physical structure and function carries universal health benefits, beyond correcting individual maladies.
Even though back adjustments represent a fundamental form of treatment employed by chiropractors; spinal adjustments and chiropractic care are not one and the same. In fact, not only do chiropractors use various techniques, but spinal manipulation itself is not exclusive to chiropractic practice. Physical therapists and osteopathic doctors from all disciplines also integrate hands-on structural manipulation into patient therapies, when appropriate.
People often seek chiropractic consultation for back pain, but other musculoskeletal disorders also benefit from treatment. Neck and shoulder pain as well as problems with extremities frequently prompt patients to seek chiropractic care, resulting in positive outcomes for a majority of those receiving the proven, complementary treatment.
Spinal Manipulation – Core Therapy Explained
Fundamentally associated with chiropractic, spinal manipulation strives to restore full mobility to joints that have developed restricted movement. The practice is also used by physical therapists and in osteopathic medicine, but when conducted in a chiropractor’s office it is commonly referred to as a “chiropractic adjustment”. To relieve pain using this type of adjustment, trained practitioners apply controlled, measured force to certain parts of the spine, realigning structures and freeing restrictions.
Chiropractors address problems caused by a single traumatic event, such as a sports injury or slip and fall accident, as well as musculoskeletal disorders resulting from recurring stress. Repeatedly bending, sitting, standing and lifting improperly or with poor posture can all cause the types of spinal conditions chiropractors treat.
Subjecting joints to trauma and ongoing stress can result in pain, inflammation and restricted function in the affected areas. Over time, poor posture and repetitive injury lead to physiological changes and associated symptoms. Chiropractic intervention strives to correct these conditions, using spinal manipulation to align joints and tissues, alleviating pain and tightness experienced by patients. Treatment also supports bodily structures’ ability to heal, leading to long-term improvements for patients experiencing chronic or recurring symptoms.
Although side effects are minor and uncommon, some patients receiving care experience soreness and discomfort similar to that of a muscle workout. In almost all cases, side effects resolve quickly, seldom carrying-on beyond a day or two.
Your Path to Practice – Building Blocks of Chiropractic Education
As the health care field evolves, more and more patients are embracing complementary forms of medicine. As a result, chiropractic is able to help a growing number of people and well-trained practitioners are in demand. For more than 25 years, the course of study leading to certification has been approved by an accrediting agency recognized by the U. S. Department of Education.
The first academic step toward practicing as a chiropractor is earning a bachelor’s degree, typically emphasizing science. During this stage in your education, it is advisable to consult with chiropractic schools on your short list, in order to address any pre-enrollment requirements for your chosen program. Undergraduate coursework leading to chiropractic school most often includes a strong science component, including extensive exposure to chemistry, biology, physics and psychology.
Equipped with a Bachelor of Science, pre-med background, you are in a position to take the next step in your education, gaining entry to an accredited chiropractic school.
Doctoral Programs Offered by Accredited Schools
Before entering practice, chiropractors undergo extensive classroom and clinical training. Typically completed in four or five years of full-time study, the rigorous educational track is similar in scope to studies undertaken by MDs and Doctors of Osteopathy.
To ensure consistency in education and competency in the field, the Council on Chiropractic Education (CCE) outlines standards for training excellence. The Council is recognized by the U.S. Department of Education as the accrediting body for Doctor of Chiropractic programs and stand-alone chiropractic schools. Accreditation with the CCE ensures quality of education and institutional integrity, reassuring not only students and the general public, but also state licensing authorities, regulatory bodies, governments, and other accrediting organizations.
CCE currently recognizes 15 accredited DC programs within the U.S., operating at 18 locations.
The standardized chiropractic curriculum is broken into progressive chapters instilling deep knowledge about the human body. Most schools adhere to a standardized course of study, beginning with two years in the classroom and laboratory, followed by two additional years gaining experience in clinical settings. All told, a chiropractor’s education encompasses at least 4200 hours spent in clinics, classrooms and laboratories. A sampling of noted U.S. programs, the following schools consistently rank among the top institutions of chiropractic education.
The University of Western States puts forth a highly ranked chiropractic program. Gaining entry into the rigorous doctoral degree program requires an undergraduate background heavy in pre-med disciplines. Entry into the college calls for particular courses, so it pays to consult in-advance, to ensure you log the necessary 90 credit hours (scoring a 3.0 GPA or higher). Official transcripts and a professional resume must be submitted for consideration, as well as a statement of purpose. Applicants may also be asked to provide additional essays and personal recommendations. A personal interview represents another important hurdle for those seeking enrollment. The school’s unique curriculum trains graduates to serve as primary care chiropractic physicians, adopting the educational standards and requisites established by the Council on Chiropractic Education.
Northwestern Health Sciences University College of Chiropractic offers an esteemed course of study, including help finishing lagging undergraduate prerequisites. The doctoral program embraces a science-based approach to education, furnishing a valuable technical foundation to the school’s integrated philosophy of medicine. Northwestern’s public and outreach clinics furnish fertile grounds for earning hands on experience, and degree candidates also put-in time working in private facilities, as part of the school’s Community Based Intern Program.
The highly specialized Texas Chiropractic College (TCC) has been educating practitioners for more than 100 years. The institution blends classroom learning with hands-on opportunities, ranking it among the best programs in the U.S. TCC graduates are fully schooled in these and other vital areas:
- Creating treatment plans
- Promoting a holistic health care philosophy
- Interacting with patients
- Running a practice
- Using cutting-edge technology
- Interpreting scientific advancement and applying them in practice
The TCC curriculum is ordered in the same sequence as the national certification exams, preparing students to begin sitting for tests as soon as possible.
Completing the course of study at the National University of Health Sciences earn graduates a prestigious Doctor of Chiropractic Medicine degree. The school’s natural care focus places students in collaboration with other providers, in an integrative learning environment. Using an evidenced-based approach, National University promotes a holistic philosophy among students, preparing graduates to:
- Perform adjustments
- Recommend supplements and herbal healing methods
- Provide nutrition and lifestyle counseling
- Administer rehabilitative therapy
In addition to its DC program, the school also offers a dual-degree option, post-graduate learning, and internships on and off campus.
Palmer College of Chiropractic maintains multiple campuses, educating students from the associate’s degree level through post-graduate studies. Sharpening critical thinking, communication skills, and problem-solving abilities are key goals of Palmer’s programs. On the road to graduation, students enjoy extensive exposure to traditional disciplines – anatomy, physiology, and neurology. And once classroom and clinical requirements are met and a student is ready to fulfill testing obligations, all of the College’s campuses boast high examination pass rates.
Certification and Licensure
Chiropractic is recognized and regulated by all fifty states, Washington D.C., Puerto Rico and the Virgin Islands. To provide treatment in any of these places, aspiring practitioners must first pass a series of national certification exams. Further, licensure must be obtained in the state or region where services will be provided.
The National Board of Chiropractic Examiners (NBCE) administers the national exams required for certification. The four-part testing process covers proficiency in these areas:
- Part I – Basic sciences
- Part II – Clinical sciences
- Part III – Clinical applications
- Part IV – While parts one-three are written exams, part four also includes a practical portion, testing proficiency in case management, chiropractic technique, and reading and interpreting diagnostic imaging.
On their way to becoming certified, students sit for these exams as they become proficient in each area. Many academic programs follow a curriculum reflecting the order of the national exams. As a result, students are able to begin meeting exam requirements before graduation, starting as early as the fifth semester.
In addition to passing national examinations, state licensure is required to practice chiropractic medicine. Each state or territory drafts its own conditions, often insisting candidates pass a test illustrating that they understand local laws related to practice. The particulars vary across state lines, but every U.S. jurisdiction requires applicants to complete an accredited Doctor of Chiropractic course of study before obtaining licensure.
A large share of licensed chiropractors practice independently or staff integrated care facilities. Core day-to-day activities typically involve evaluating and caring for patients, but clinicians enjoy considerable flexibility in terms of therapy methods and specialties.
In addition to private practice and complementary care clinics, the services provided by DCs are made available through U.S. Federal health delivery systems, including Medicaid, care furnished by the VA, and the Federal Employees Health Benefits Program.
Multidisciplinary clinical settings also draw chiropractors, rounding-out services such as acupuncture, massage therapy, and other alternative care.
According to the Bureau of Labor Statistics the chiropractic profession is poised for rapid growth through 2024. Projected to expand 17% during the period, the job outlook for the field exceeds average job growth across all vocations. Growing interest in natural healing methods is thought to account for some of this increase. And as the Baby Boomer population continues to age, the demand for chiropractic reflects the demographic spike.
The median income earned by chiropractors in 2015 was close to 64K annually, but salaries of more than $100,000 are common in the field. The top ten-percent of earners, for example, take home salaries exceeding $140,000 annually. Like members of other professions, chiropractors earn modest salaries at the beginning of their careers, progressively advancing their earning potential over time.
Industry Advocacy and Support Organizations
The American Chiropractic Association (ACA) is the largest association representing doctors of chiropractic. The organization is concerned with general promotion, advancing the interests of the profession as a whole, but also undertakes a role ensuring quality care results from every chiropractic interaction. The ACA endorses and furthers the highest possible standards within the industry, lobbying for pro-chiropractic legislation and increased access to education for those entering the field.
Through collaboration with other health care professionals, the ACA works to influence public policy and regulatory practices. Stressing the value of a fully integrated health care delivery model, in which chiropractors add value, reduce costs, and consistently deliver services at a high level, the ACA strives to enhance personal and public health and wellness, while also improving the United States health care system.
The American Chiropractic Foundation (ACF) is dedicated to promoting research, education and charity in areas related to the practice. Advocating for training and education within the profession, the organization also plays an active role raising awareness about chiropractic services and the importance of fully integrating the discipline into every health care model.
In its role protecting members of the profession, the ACF furnishes a forum for practicing chiropractors and members of the public with questions and concerns about adjustments and other aspects of chiropractic therapy. As an advocate for professionals and patients, the organization also has a hand in training protocols, helping define best practices and ensuring the highest possible level of service for each patient.
The ACF administers several scholarships for students seeking entry into the profession. The annual scholarship awards recognize students enrolled full-time at accredited institutions, pursuing chiropractic credentials. Eligibility calls for a requisite 2.75 GPA and student in good standing status. Qualified candidates are invited to apply directly with the ACF.
Chiro-org is a unique project, compiling information and resources for practitioners. Originally established twenty years ago by a group of practicing chiropractors, the organization is still run by DCs. From research journals and links to published studies to a series of forms doctors can use in practice, the free site gives back to the profession.
The ACA Sports Council (ACASC) The Sports Council is a growing membership organization, drawing from active practitioners interested in chiropractic’s role treating sports injuries and promoting physical fitness. Members of the organization work closely with athletic organizations and allied health professionals, conveying the value of the treatment. ACASCs annual symposium brings together stakeholders for sports medicine education. The NFL Players Association, for example, has embraced chiropractic as an integral part of rehabilitative therapy.
The International Chiropractors Association (ICA) is a longstanding professional organization supporting members across the world. The group not only strives to advance awareness and recognition of the values of chiropractic, but the ICA also pledges to empower better health outcomes through universal chiropractic standards. The Association’s goals, among others, include:
- Protecting the traditional, natural integrity of the profession, which is committed to providing drug and surgery-free relief
- Providing leadership for licensure across the world
- Advocating for quality chiropractic education
- Advancing the profession and its members through continuing education, research, and social action
- Promoting professional, ethical, and professional standards in the field
- Integrating chiropractic into all heath care delivery programs
Through its student organization, ICA administers multiple annual scholarships for students entering chiropractic, including the Arnold Schwarzenegger Chiropractic Scholarship. The award was launched in partnership with the former California governor, a longtime ICA supporter, recognizing his contributions to the field.
As health care needs and philosophies continue to evolve, the demand for chiropractic care is increasing. Career growth is expected to expand the size of the industry by double-digits over the coming decade. Unemployment in the field is very low and annual salaries for certified professionals often exceed $100,000 annually. Flexible practice options add further appeal to career prospects in chiropractic, empowering DCs to work in clinics, private practice and research settings. If a hands-on health care career is in your future, earning a DC degree sets you on a proven path to professional success.