Chiropractic – An American Invention

by Ainoura Oussenbec

January 16, 2019

Chiropractic care was born about 120 years ago in the United States, when an Iowan school teacher, Daniel Palmer, made his first successful chiropractic adjustment on a person with a displaced vertebra. Daniel Palmer was interested in everything medical and scientific, and was fascinated by different forms of manual manipulations practiced in many cultures for centuries. As he realized no unified system existed to explain and codify the successes of manual manipulation, D. Palmer devoted his life to developing chiropractic as a distinct medical field. In 1897, he established the Palmer College of Chiropractic in Davenport, Iowa, where it remains active today.

To pioneer a completely new field in health care was no easy feat. Health care is highly regulated and slow to accept new and unproven methods, for a good reason. Though chiropractic care has gradually gained traction in the country, the medical establishment has not fully accepted chiropractic due to lack of scientific evidence of its efficacy. Still, chiropractic care is now widely available around the nation and is covered by most insurance plans.

In 1970, there were an estimated 13,000 chiropractors licensed in the United States (Cooper, 1996). By the year 1990, that number more than tripled to reach about 40,000. Today, there are more than 70,000 chiropractic licenses (active and inactive) in the United States. According to Bureau of Labor Statistics, 33,630 chiropractors are employed in various organizations while the rest of the licenses probably belong to self-employed chiropractors or those who keep a license but do not practice for various reasons.

Today, many other countries recognize and regulate chiropractic care, including Canada, Mexico, Great Britain, Australia, Japan, and Switzerland.

What Is Chiropractic?

The word ‘chiropractic’ comes from the Greek and means “to be done by hand.” Chiropractors assess, treat, and care for patients by manipulation of the spine and musculoskeletal system. They may provide spinal adjustment or address sacral or pelvic misalignment. The purpose of spinal manipulation is to restore joint mobility by manually applying a controlled force into joints that have become restricted in their movement due to a tissue injury. The idea is that misaligned joints and spine can have negative effects on the rest of the body, causing pain and dysfunction.

Chiropractors must earn Doctor of Chiropractic (D.C.) degree, which typically takes four years to complete. For admission, chiropractic students are required to have at least three years undergraduate college education. After earning the degree, chiropractors must pass national board exams before obtaining a state license to practice, and then must maintain their license annually by earning continuing education (CE) credits through state-approved CE programs.

Chiropractic training includes general courses in anatomy, biology, chemistry, and related disciplines. In addition, chiropractors train to provide advice on therapeutic and rehabilitative exercises, as well as nutritional, dietary, and lifestyle counseling.

Training Is Less Extensive than for Other Doctors

There is sometimes confusion about chiropractors, physical therapists, and osteopaths, because these occupations may appear similar.

A chiropractor focuses only on conditions of the musculoskeletal system and nervous system and the effects caused by these conditions. Physical therapists, on the other hand, diagnose and treat conditions in order to restore physical movement and function. Osteopaths are trained and licensed for medical and surgical specialties as well as in manual diagnosis and treatment, and can prescribe medications just like medical doctors.

Chiropractors are thus not fully licensed medical doctors. They do not diagnose or prescribe medications, and are not required to have completed internship and residency training in a hospital.

Chiropractors in Oregon: Slow Growth, Wide Range of Salaries

Oregon requires chiropractic registration annually for both active and inactive practitioners. A Chiropractic Specialty Certification is required by Oregon Board of Chiropractic Examiners. The typical entry-level education for this occupation in Oregon is a doctoral or professional degree.

Only one school in the state of Oregon provides a four-year Doctor’s degree in chiropractic care – University of Western States in Portland. In 2016, the school graduated 120 new chiropractic professionals.

According to the Board, there are currently 1,704 active licenses for chiropractors in the state of Oregon, with 1,021 chiropractors working as employees and as self-employed practitioners. Not all chiropractors with active licenses may be practicing at any given time.

The number of practicing chiropractors in Oregon tripled between 2002 and 2012. However, the growth between 2014 and 2017 was insignificant, from 1,017 to 1,021, which may indicate beginning of saturation in the field, at least for Oregon. About half of the state’s chiropractors are practicing in the Portland Tri-County area. By 2027, the overall number of chiropractors is expected to increase by 16.1 percent, according to the Oregon Employment Department’s employment projections.

For those chiropractors employed in various health care facilities (not self-employed), the salaries can start at $14 per hour and can go up to $78 per hour, depending on experience and location in Oregon. The annual average salary for chiropractors in Oregon is $82,390, though the average is only about $56,000 in Eastern counties and the Rogue Valley. In the Portland Metro area, chiropractors earn more than $90,000 annually, on average.
Popular but Still Controversial

About half of adults in the U.S. have been to chiropractor as a patient, according to the Gallup-Palmer College of Chiropractic Inaugural Report of 2015. More than half of U.S. adults view chiropractors positively and agree that they are effective at treating neck and back pain. However, uncertainty about costs and the potential dangers associated with chiropractic care could be barriers to some adults considering the use of chiropractic.

Chiropractors themselves still have disagreements within their profession, including about ethical issues and business practices. Some chiropractors reportedly advertise unreasonable and unproven claims or encourage patients to sign up for multiple treatments that may not be justified. Other chiropractors stick to the narrow and essential functions of their role and work closely with the medical establishment as a support modality. Differences regarding professional standards thus contribute to continued controversy and a degree of distrust among both patients and other health care professionals. Many on both sides of the argument agree that more scientific research is needed into the methods and efficacy of chiropractic care.

Today, chiropractic services are broadly available around the nation, covered by most insurance plans, and have a loyal following among many patients. However, chiropractors still have a lot of work to gain full acceptance in the medical field and among the wider population.

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