Education & Careers
What Chiropractors Do
Chiropractors perform manual therapy to help patients with back and neck pain.
Chiropractors care for patients with health problems relating to the neuromusculoskeletal system, which includes nerves, bones, muscles, ligaments, and tendons. They use spinal adjustments and manipulation, and other techniques to manage patients’ health concerns, such as back pain, neck pain and headaches.
Chiropractors typically do the following:
- Assess a patient’s medical condition by reviewing their medical history, listening to the patient’s concerns, and performing a physical examination
- Analyze the patient’s posture, spine, and reflexes
- Conduct tests, including evaluating a patient’s posture and taking x rays
- Provide neuromusculoskeletal therapy, which involves adjusting a patient’s spinal column and other joints by hand
- Give additional treatments, such as applying heat or cold and other modalities to a patient’s injured areas to decrease pain and enhance healing
- Advise patients on health and lifestyle issues, such as exercise, nutrition, and sleep habits
- Refer patients to other healthcare professionals, if needed
Chiropractors focus on patients’ overall health. Chiropractors believe that misalignments of the spinal joints interfere with a person’s neuromuscular system and can result various painful syndromes as well as other conditions of poor health.
Some chiropractors use procedures such as massage therapy, rehabilitative exercise, low level laser, traction, electrical stimulation and ultrasound in addition to spinal adjustments and manipulation. They also may apply supports, such as braces or shoe inserts, to treat patients improve posture and relieve pain.
In addition to operating a general chiropractic practice, some chiropractors concentrate in areas such as sports, neurology, orthopedics, pediatrics, or nutrition, among others. Chiropractors in private practice are responsible for marketing their businesses, hiring staff, and keeping records.
Chiropractors assess a patient’s medical condition and explain treatment options.
As of 2016, there are an estimated 75,000 licensed Doctors of Chiropractic in the United States. Most chiropractors work in a solo or group practice. About 1 in 3 was self-employed in 2016. A small number work in hospitals, physicians’ offices or multispecialty clinics.
Chiropractors typically work in office settings. They may be on their feet for long periods when examining and treating patients.
Although most chiropractors worked full time, about 1 in 4 worked part time in 2016. Chiropractors may work in the evenings or on weekends to accommodate working patients. Self-employed chiropractors set their own hours.
How to Become a Doctor of Chiropractic
Becoming a chiropractor requires earning a Doctor of Chiropractic (D.C.) degree and obtaining a state license.
Doctor of Chiropractic programs typically take 4 years to complete and require at least 3 years (preferably 4 years) of undergraduate college education for admission.
Prospective chiropractors are required to have a Doctor of Chiropractic (D.C.) degree—a postgraduate professional degree that typically takes 4 years to complete. In 2016, there are 14 Doctor of Chiropractic programs on 18 campuses, accredited by The Council on Chiropractic Education.
Admission to D.C. programs requires at least 90 semester hours of undergraduate education, with courses in the liberal arts and sciences, such as physics, chemistry, and biology. However, many students earn a bachelor’s degree before applying to a chiropractic program.
Chiropractic education generally consists of classroom work in:
- public health
- physical, clinical and laboratory diagnosis
- gynecology & obstetrics
- diagnostic imaging procedures
- first aid and emergency procedures
- spinal analysis
- principles and practice of chiropractic
- clinical decision making
- adjustive techniques
- research methods and procedures
- professional practice ethics
- business management and billing and finance.
Chiropractic students also get supervised clinical experience, with some institutions incorporating hospital rotations for their students.
Some chiropractors complete postgraduate programs offered by associations leading to Diplomate status. These programs provide additional training in specialty areas, such as radiology, orthopedics, rehabilitation and pediatrics, encompassing a minimum of 300 hours. Classes are taken at chiropractic colleges and other off-campus conference facilities. Others may choose to earn a master’s degree in a related topic, such as nutrition or sports rehabilitation. Some D.C. programs offer a dual-degree option, in which students may earn a master’s degree in a second topic while completing their D.C. degree.
Licenses, Certifications, and Registrations
All states and the District of Columbia require chiropractors to be licensed. Although specific requirements vary by state, all jurisdictions require the completion of an accredited Doctor of Chiropractic (D.C.) program. Some states require chiropractors to have a bachelor’s degree prior to entering chiropractic college.
In addition, all jurisdictions require passing an examination set by the National Board of Chiropractic Examiners, which includes basic and clinical sciences, clinical case studies, and a practical exam. Many jurisdictions also require applicants to pass state-specific law exams, called jurisprudence exams. All states require continuing education to maintain a chiropractic license.
- Decision-making skills. Chiropractors must determine the best course of action when treating a patient. They must also decide when to refer patients to other healthcare professionals.
- Detail oriented. Chiropractors must be observant and pay attention to details so that they can make proper diagnoses and avoid mistakes that could harm patients.
- Dexterity. Because they use their hands to perform manual adjustments to the spine and other joints, chiropractors should have good coordination to perform therapy effectively.
- Empathy. Chiropractors often care for people who are in pain. They must be understanding and sympathetic to their patients’ problems and needs.
- Interpersonal skills. Chiropractors must be personable in order to keep clients coming to their practice. Also, because chiropractors frequently touch patients in performing therapy, they should be able to put their patients at ease.
Source: Chiropractic Economics, May 20, 2016
The national average annual wage for chiropractors in 2015-16 was $81,542, (Indiana: $103,980), with a national average total compensation of $147,334. Average national gross billings amounted to $$689,092, with national average gross collections reported as $384,627, for a collection rate of 56%.
Chiropractors tend to earn significantly less early in their careers. A recently graduated Doctor of Chiropractic may expect to earn $58,708 as an associate within an established clinic, and then earn more as they build a client base and become owners of, or partners in, a practice.
Although most chiropractors worked full time, about 1 in 4 worked part time in 2015 -16. Offices of chiropractors may stay open in the evenings or on weekends to accommodate working patients. Self-employed chiropractors set their own hours.
Source: U.S. Bureau of Labor Statistics, Employment Projections program
Employment of chiropractors is projected to grow 17 percent from 2016 to 2024, much faster than the average for all occupations. People across all age groups are increasingly becoming interested in alternative or complementary healthcare. Chiropractic care is appealing to patients because chiropractors use nonsurgical methods of treatment and do not prescribe drugs.
Chiropractic treatment of the back, neck, limbs, and involved joints has become more accepted as a result of research and changing attitudes about additional approaches to healthcare. As a result, chiropractors are increasingly working with other healthcare workers, such as physicians and physical therapists, through referrals and complementary care.
The aging of the large baby-boom generation will lead to new opportunities for chiropractors. Older adults are more likely to have neuromusculoskeletal and joint problems and they are seeking treatment for these conditions more often as they lead longer, more active lives.
Demand for chiropractic treatment is related to the ability of patients to pay, either directly or through health insurance. Although most insurance plans now cover chiropractic services, the extent of such coverage varies among plans. However, the number of individuals who have access to health insurance is expected to continue to increase because of federal health insurance reform.
Chiropractic Economics, May 20, 2016
Bureau of Labor Statistics, Occupational Outlook Handbook, 2016