By Michael Dorausch, D.C.
For nearly twelve years I have been answering questions from persons interested in more information regarding chiropractic and chiropractor schooling requirements. I am not offering advice on which schools to attend, not in this article. I have not been paid by any 3rd party for any of the content I am providing here. The information you will read here is the most current and accurate data (that I know of) regarding this topic. The majority of source information for this topic comes from the Occupational Outlook Handbook (2006) which is published by the U.S. Department of Labor – Bureau of Labor Statistics.
Rather than make assumptions, spin data and provide false information, I have posted the text exactly as I received it, thanks in part to the Freedom of Information Act (FOIA). This provides us with a true source of reliable information. To further clarify, I have used the term BLS (for Bureau of Labor Statistics) to differentiate from my own comments which are preceded by the term Thoughts.
My own personal thoughts and insights are in part based on my experience of 12 plus years being in direct contact and communication with several thousand doctors of chiropractic who are in the field practicing, relationships with three current chiropractic college presidents, numerous post graduate professors, educators, practice management consultants and mentors.
Before we address this topic let me say that I have been there. I attended and graduated chiropractic college. I attended pre-chiropractic college. I’ve taken State and National boards. I struggled, I saved, I borrowed, and I paid my own way through school. I did so no differently than thousands of other DCs I interact with regularly. In future articles we will get into more specifics and details of chiropractic schooling and practice. The purpose of this article is to bring you the most recent data on the topic of chiropractic practice.
So just what is the United States Department of Labor currently saying about the practice of chiropractic?
Chiropractic: Bureau of Labor Statistics
Advice about Chiropractic Schools
BLS: Job prospects should be good; employment is expected to increase faster than average as consumer demand for alternative health care grows.
Thoughts: I have met, spoken on the phone, or communicated via email with far too many students, potential students or recent graduates that I believe are in some sort of “fantasy land.” A DC degree does not entitle anyone to a salary anywhere. Job prospects should be good, but expect to go to work.
BLS: Chiropractors must be licensed, requiring 2 to 4 years of undergraduate education, the completion of a 4-year chiropractic college course, and passing scores on national and State examinations.
Thoughts: Focus on your education, pass your exams, get your license. You won’t do anyone any good in the U.S. without it.
BLS: About 58 percent of chiropractors are self-employed.
Thoughts: I am self employed so you can count me in the majority. I love having my own office but it may not be right for you.
BLS: Earnings are relatively low in the beginning, but increase as the practice grows.
Thoughts: Earnings may be relatively low to non-existent in the beginning. Just like in starting any business. A successful chiropractor has some sort of business plan to allow them to continue living within their means while they grow their practice.
Training, Other Qualifications, and Advancement
BLS: All States and the District of Columbia regulate the practice of chiropractic and grant licenses to chiropractors who meet the educational and examination requirements established by the State. Chiropractors can practice only 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 their educational, examination, and practice credentials meet State specifications.
Thoughts: Take your exams and prepare to get your license as early as possible. Upon graduation from college is not the time to go on permanent vacation. You may have to continue working at your part time job (if you had one) or remain living at home with parents, roommates, friends, or whatever it was you were doing. While you are in school (or even before) give some serious thought as to where you may want to practice. Take exams and create a plan to become licensed in all your preferred states.
It’s not uncommon for example to be licensed in New York and Florida, or New Jersey and Florida, or Nevada, California and Arizona. If I was a chiropractic student in Texas I’d consider getting licensed in that state and would then get licensed in the state I planned to live and practice in.
BLS: Most State boards require at least 2 years of undergraduate education; an increasing number are requiring a 4-year bachelor’s degree. All boards require the completion of a 4-year program at an accredited chiropractic college leading to the Doctor of Chiropractic degree.
Thoughts: The idea is that there will be more schooling instead of less. 4+4=8
BLS: 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. All States except New Jersey require the completion of a specified number of hours of continuing education each year in order to maintain licensure. Chiropractic associations and accredited chiropractic programs and institutions offer continuing education programs.
Thoughts: New Jersey is DEFINITELY a state I would consider getting licensed in. I say this because there are some fine chiropractors there and the state has probably the best professional mentoring network I know of. Florida, Michigan, Pennsylvania, New York and Texas have strong groups of doctors that work together. This is one of those things you typically don’t think about while in school. My experience has taught me that fellowship is EVERYTHING in becoming and maintaining success as a doctor of chiropractic. There is no better way to learn something than to teach it to others. Similarly, the cooperation in working together to accomplish shared goals results in outcomes that are beneficial to ones self and beneficial to all other group members.
BLS: In 2005, 15 chiropractic programs and 2 chiropractic institutions in the United States were accredited by the Council on Chiropractic Education. Applicants are required to have at least 90 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.
Thoughts: 10 years ago I may have said much of the prerequisite education was nonsense, I don’t feel that way today. Notice that BLS talks of “prechiropractic study” and not “premedicine study.” I still believe most medical study taught to chiropractic students is a waste of valuable education. Medicine as health care is a completely different system from chiropractic and should be taught to those planning to practice medicine. I believe we run into problems and create confusion when we do otherwise. That being said, psychology, social sciences and humanities are very valuable studies to the DC. The sciences such as physics and chemistry are equally important. Today, I am thankful for the very solid prechiropractic education that I had. Like many others, at the time I thought “what does this have to do with being a chiropractor?”
BLS: Chiropractic programs require a minimum of 4,200 hours of combined classroom, laboratory, and clinical experience. 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 adjustment 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.
Thoughts: Nice to see that BLS lists manipulation and spinal adjustment individually and recognizes they are two separate things. Coursework may involve classes teaching manipulation of a shoulder, elbow, wrist, knee, or ankle which differs from spinal adjustment work. It is also important to take note of the fact that BLS recognizes chiropractic programs and institutions exclusively as granting the degree of Doctor of Chiropractic. The result is a separate and distinctly different educational, professional, licensing, and regulatory, experience from that of a doctor of medicine. The study of things medical does not a chiropractor make. As I read it, in no state in the US is a medical doctor qualified or licensed to determine the need for chiropractic care for any being, whether that being be human or animal. Common sense tells us the only exception would be a doctor who has a degree from a recognized chiropractic program or institution. In that case, they would have a DC degree.
BLS: Chiropractic colleges also offer Postdoctoral training in orthopedics, neurology, sports injuries, nutrition, rehabilitation, radiology, industrial consulting, family practice, pediatrics, and applied chiropractic sciences. Once such training is complete, chiropractors may take specialty exams leading to “diplomate” status in a given specialty. Exams are administered by specialty chiropractic associations.
Thoughts: You can spend the rest of your life in postdoctoral training. It is not necessary for anyone to do so but if you are passionate about being a chiropractor, chances are you’ll want to hang out with others and continue learning for as long as you can. After eight years, I still continue to go for monthly training in postdoctoral work. I believe doing so keeps you fresh and connected to what is going on in the world. Not mentioned above is postdoctoral study in philosophy. For example, the Palmer University system has a Diplomate in Philosophical Chiropractic Standards (DPhCS) program.
BLS: Chiropractic requires keen observation to detect physical abnormalities. It also takes considerable manual dexterity, but not unusual strength or endurance, to perform adjustments. 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.
Thoughts: Well stated. Big chiropractors don’t make them better adjusters, nor are men better suited for chiropractic work than women. Empathy, understanding, and the desire to help others, in my opinion, are essential to a successful practice and life experience.
BLS: Newly licensed chiropractors can set up a new practice, purchase an established one, or enter into partnership with an established practitioner. They also may take a salaried position with an established chiropractor, a group practice, or a health care facility.
Thoughts: Success stories abound but failure and misery loves company. Before doing anything, newly licensed chiropractors had better have a plan of action and must act on that plan in order to succeed.
Tomorrow we’ll cover more on Chiropractic Jobs & Employment