• Employment of chiropractors is expected to increase rapidly and job prospects should be good.
• Chiropractic care of back, neck, extremities, and other joint damage has become more accepted as a result of recent research and changing attitudes.
• In chiropractic, as in other types of independent practice, earnings are relatively low in the beginning, but increase as the practice grows.

Nature of Work

Chiropractors, also known as doctors of chiropractic or chiropractic physicians, 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, and that skeletal imbalance through joint or articular dysfunction, especially in the spine, can cause pain.

The chiropractic approach to health care is holistic, stressing the patient’s overall health and wellness. 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 common to chiropractic diagnosis.

In cases in which difficulties can be traced to involvement of musculoskeletal structures, chiropractors manually adjust the spinal column. Many chiropractors use water, light, massage, ultrasound, electric, and heat therapy. They may also apply supports such as straps, tapes, and braces. Chiropractors counsel patients about wellness concepts such as nutrition, exercise, lifestyle changes, 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.

Many 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.

Working Conditions

Chiropractors work in clean, comfortable offices. The average workweek is about 40 hours, although longer hours are not uncommon. Solo practitioners set their own hours, but may work evenings or weekends to accommodate patients.

Chiropractors, like other health practitioners, are sometimes on their feet for long periods of time. Chiropractors who take x rays employ appropriate precautions against the dangers of repeated exposure to radiation.

Employment

Chiropractors held about 46,000 jobs in 1998. Most chiropractors are in solo practice, although some are in group practice or work for other chiropractors. A small number teach, conduct research at chiropractic institutions, or work in hospitals and clinics.

Many chiropractors are located in small communities. There are geographic imbalances in the distribution of chiropractors, in part because many establish practices close to chiropractic institutions.

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 and examination requirements established by the State. Chiropractors can only practice in States where they are licensed. Some States have agreements permitting chiropractors licensed in one State to obtain a license in another without further examination, provided that educational, examination, and practice credentials meet State specifications.

Most State boards require at least 2 years of undergraduate education, and an increasing number require a 4-year bachelor’s degree. All boards require completion of a 4-year chiropractic college course at an accredited program leading to the Doctor of Chiropractic degree.

For licensure, most State boards recognize either all or part of the four-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 programs and institutions, 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, diagnostic imaging, thermography, and internal disorders.

In 1998, there were 16 chiropractic programs and institutions in the United States accredited by the Council on Chiropractic Education. All required applicants to have at least 60 semester hours of undergraduate study leading toward a bachelor’s degree, including courses in English, the social sciences or humanities, organic and inorganic chemistry, biology, physics, and psychology. Many applicants have a bachelor’s degree, which may eventually become the minimum entry requirement. Several chiropractic colleges offer prechiropractic study, as well as a bachelor’s degree program. Recognition of prechiropractic education offered by chiropractic colleges varies among the State boards.

During the first 2 years, most chiropractic programs 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 manipulation and spinal adjustments, and provide clinical experience in physical and laboratory diagnosis, neurology, orthopedics, geriatrics, physiotherapy, and nutrition. Chiropractic programs and institutions 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 adjustments, 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 good 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.

Job Outlook

Job prospects are expected to be good for persons who enter the practice of chiropractic. Employment of chiropractors is expected to grow faster than the average for all occupations through the year 2008 as consumer demand for alternative medicine grows. Chiropractors emphasize the importance of healthy lifestyles and do not prescribe drugs or perform surgery. As a result, chiropractic care is appealing to many health-conscious Americans. Chiropractic treatment of back, neck, extremities, and other joint damage has become more accepted as a result of recent research and changing attitudes about alternative health care practices. The rapidly expanding older population, with their increased likelihood of mechanical and structural problems, will also increase demand.

Demand for chiropractic treatment is also related to the ability of patients to pay, either directly or through health insurance. Although more insurance plans now cover chiropractic services, the extent of such coverage varies among plans. Increasingly, chiropractors must educate communities about the benefits of chiropractic care in order to establish a successful practice.

In this occupation, replacement needs arise almost entirely from retirements. Chiropractors usually remain in the occupation until they retire; few transfer to other occupations. Establishing a new practice will be easiest in areas with a low concentration of chiropractors.

Earnings

Median annual earnings of salaried chiropractors were $63,930 in 1998. The middle 50 percent earned between $36,820 and $110,820 a year.

Self-employed chiropractors usually earn more than salaried chiropractors. According to the American Chiropractic Association, average income for all chiropractors, including the self-employed, was about $86,500, after expenses, in 1997. In chiropractic, as in other types of independent practice, earnings are relatively low in the beginning, and increase as the practice grows. 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 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

Disclaimer: Links to non-BLS Internet sites are provided for your convenience and do not constitute an endorsement.

General information on chiropractic as a career is available from:

• American Chiropractic Association, 1701 Clarendon Blvd., Arlington, VA 22209. Internet: http://www.amerchiro.org

   

• International Chiropractors Association, 1110 North Glebe Rd., Suite 1000, Arlington, VA 22201. Internet: http://www.chiropractic.org

   

• World Chiropractic Alliance, 2950 N. Dobson Rd., Suite 1, Chandler, AZ 85224-1802.

   

• Dynamic Chiropractic, P.O. Box 6100, Huntington, CA 92615. Internet: http://www.chiroweb.com

For a list of chiropractic programs and institutions, as well as general information on chiropractic education, 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. Internet: http://www.fclb.org

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.

An industry employing chiropractors that appears in the 2000-01 Career Guide to Industries: Health services

Information from: http://stats.bls.gov/oco/ocos071.htm