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Chiropractors

Health Diagnosing and Treating Practitioners

(D.O.T.  079.101-010)

Nature of the Work

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.
Interference with these systems is believed to impair normal
functions and lower resistance to disease.  Chiropractors hold that
misalignment of spinal vertebrae or irritation of the spinal nerves
can alter 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 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 are an important diagnostic tool 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
about nutrition, exercise, and stress management, but do not
prescribe drugs or perform surgery.

   Some chiropractors specialize in athletic injuries, neurology,
orthopedics, nutrition and internal disorders.  Others specialize in
taking and interpreting x rays and other diagnostic images.

   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.

   X rays are an important diagnostic tool.


Working Conditions

Chiropractors work in clean, comfortable offices.  The average
workweek is about 43 hours.  Chiropractors who work for themselves
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.

Employment

Chiropractors held about 46,000 jobs in 1992.  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.

Training, Other Qualifications, and Advancement

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 another State to obtain a license 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 4-year
bachelors' 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 1992, 14 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 have a number of options: They can set
up a new practice, purchase an established one, enter into
partnership with an established practitioner, take a salaried
position with an established chiropractor to acquire the experience
and the funds needed to equip and open an office, or apply for a
residency program.

Job Outlook

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.  As a
result, employment of chiropractors is expected to grow faster than
the average through the year 2005.

   In this occupation, replacement needs arise almost entirely from
retirements and deaths.  Chiropractors generally remain in the
occupation until they retire; few transfer to other occupations.

Earnings

In 1992, median income for chiropractors was about $70,000, 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 1992, the lowest 10 percent of chiropractors had median
net incomes of $21,000 or less, and the highest 10 percent earned
$190,000 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.

Related Occupations

Chiropractors diagnose, treat, and work to prevent bodily disorders
and injuries.  So do physicians, dentists, optometrists,
podiatrists, veterinarians, occupational therapists, and physical
therapists.

Sources of Additional Information

   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, 4401 Westown Pky., Suite 120,
West Des Moines, IA 50266.

   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.