There are in excess of 69,000 licensed Doctors of Chiropractic (DCs) in North America, with many more practicing worldwide. (1) What are the educational requirements to become a DC? What is the scope of chiropractic practice? What does the future hold for the profession?
According to the American Chiropractic Association (ACA), typical chiropractic matriculates have completed nearly 4 years of pre-medical undergraduate instruction in courses like physics, chemistry, psychology, and other required areas.(2) To earn the DC degree, a doctoral candidate will spend approximately 4,820 hours in a professional chiropractic program.(3) And this figure does not include post-graduate education in specialty disciplines such as acupuncture, neurology, orthopedics, and other training.
The Council on Chiropractic Education (CCE) is the agency recognized by the U.S. Secretary of Education for accreditation of programs and institutions offering the doctor of chiropractic degree. CCE states that DC programs “are structured and integrated in a manner that enables the student to demonstrate attainment of all required clinical competencies and function as a chiropractic primary care physician with a neuromusculoskeletal emphasis upon graduation.”(4) To this end, CCE required coursework must include(5):
•Basic Sciences (anatomy, physiology, biochemistry, microbiology, pathology)
•Clinical Sciences [physical, clinical and laboratory diagnosis; diagnostic imaging; spinal analysis; orthopedics; biomechanics; neurology; spinal adjustive techniques; rehabilitation and therapeutic modalities (active and passive care) and extremities manipulation techniques; lifelong patient management; nutrition; organ systems; first aid and emergency procedures; public health; clinical decision making]
•Behavioral and Socioeconomic Topics (principles and practice of chiropractic; ethics and integrity; jurisprudence; business and practice management; psychology; professional communications)
•Information Literacy and Research Methodology
Doctors of chiropractic have a significant scope of responsibility. NBCE, the principal organization charged with national testing for DC candidates, states: “The practice of chiropractic includes establishing a diagnosis, facilitating neurological and biomechanical integrity through appropriate chiropractic case management, and promoting health.”(6) Unlike other disciplines that may over-focus on disease, NBCE describes chiropractic as “…a health care discipline [emphasis added] which emphasizes the inherent recuperative power of the body to heal itself without the use of drugs or surgery. The practice of chiropractic focuses on the relationship between structure (primarily the spine) and function (as coordinated by the nervous system) and how that relationship affects the preservation and restoration of health.”(7) Indeed, it may be the chiropractic philosophy on health and healing that propels the profession forward into an expanded leadership role.
NBCE, the ACA, and other leading chiropractic organizations recognize that chiropractic has a unique and important role in our emerging and evolving health care system. A growing body of research exists to substantiate the value of chiropractic care for a growing number of conditions, from whiplash to low back pain, from colic in babies (8) to arthritis management (9,10) in seniors. While disease and disability are substantial concerns for our many populations (active, sedentary, ageing, etc.), chiropractic is special in that it focuses on illness prevention and the role of the nervous system in health and healing. The current “sick care” system has failed, with national health expenditures for sickness, injury, and age-related disease on an ever-rising curve.(11) NBCE states, “The chiropractic approach to wellness typifies a changing attitude toward health care in the United States. Chiropractic tenets include the principle that an individual’s nervous system is very important to health and that interference with this system impairs normal functions and lowers the body’s resistance to disease. The study of chiropractic includes the mechanisms by which the nervous system may be irritated or otherwise interfered with and result in aberrant reflexes. Chiropractic practice incorporates techniques for the correction of these pathological mechanisms.”(12)
Written by Daniel A. Shaye, DC, CCSP, FIAMA
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1A Project Report, Survey Analysis, & Summary of the Practice of Chiropractic within the US. Natl. Board of Chiropractic Examiners (NBCE), Greeley, CO. Jan 2005. Pg 1. 2 SO: The Am. Chiropractic Assn., as quoted at http://www.acatoday.org/pdf/Edu_Reqs.pdf, pg. 1.; 3 Ibid. ; 4 CCE Accreditation Standards, draft dated Jan 2012, pg. 20, as reported at http://www.cce-usa.org/uploads/DRAFT_2009-7_CCE_ACCREDITATION_STANDARDS.pdf ; 5 CCE Accreditation Standards, draft dated Jan 2012, pg. 21-22, as reported at http://www.cce-usa.org/uploads/DRAFT_2009-7_CCE_ACCREDITATION_STANDARDS.pdf.; 6 A Project Report, Survey Analysis, & Summary of the Practice of Chiropractic within the US. NBCE, Greeley, CO. Jan 2005. Pg 141.; 7 A Project Report, Survey Analysis, & Summary of the Practice of Chiropractic within the US. NBCE, Greeley, CO. Jan 2005. Pg 140.; 8 Wiberg JMM, Nordsteen J, Nilsson N. The short-term effect of spinal manipulation in the treatment of infantile colic: A randomized controlled clinical trial with a blinded observer. J Manipulative Physiol Ther 1999;22:517-22.; 9 Rao JK, Mihaliak K, Kroenke K, Bradley J, Tierney WM, Weinberger M. Use of complementary therapies for arthritis among patients of rheumatologists. Ann Intern Med 1999;131:409-416. 10 WebMD article at http://www.webmd.com/back-pain/chiropractic-pain-relief. 11 Celebrate Wellness! Vol 2, No. 6 (“Investing in Wellness”). 12 A Project Report, Survey Analysis, & Summary of the Practice of Chiropractic within the US. NBCE, Greeley, CO. Jan 2005. Pg 2.