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The following is excerpted from various sources of Chiropractic information: :

1. What is Chiropractic?
2. What is a Doctor of Chiropractic?
3. What are the educational requirements to become a Doctor of Chiropractic?
4. What credentials are required of a Doctor of Chiropractic?
5. What can I expect from a Doctor of Chiropractic?
6. What is being done in the area of Chiropractic research?

Copyright© 2001 by Computer Information Exchange.  All rights reserved.

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1. What is Chiropractic? 

Chiropractic is a branch of the healing arts that focuses on the inherent ability of the body to heal without the use of drugs or surgery. The application of science in chiropractic concerns itself with the relationship between structure (primarily the spine) and function, as coordinated by the nervous system of the human body, and as that relationship may affect the restoration and preservation of health.

Information source: The Council on Chiropractic Education (CCE) — http://www.cce-usa.org

THE ACC CHIROPRACTIC PARADIGM

Purpose
The purpose of chiropractic is to optimize health.

Principle  
The body’s innate recuperative power is affected by and integrated through the nervous system.

Practice
The practice of chiropractic includes:

• establishing a diagnosis;
• facilitating neurological and biomechanical integrity through appropriate chiropractic case management; and
• promoting health.

Foundation  
The foundation of chiropractic includes philosophy, science, art, knowledge, and clinical experience.

“The ACC Chiropractic Paradigm” is developed by the Association of Chiropractic Colleges — http://www.chirocolleges.org

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2. What is a Doctor of Chiropractic?

A Doctor of Chiropractic is a physician whose purpose is to help meet the health needs of the public, giving particular attention to the structural and neurological aspects of the body. The practice of Chiropractic includes:

• establishing a diagnosis;
• facilitating neurological and biomechanical integrity through appropriate chiropractic case management; and
• promoting health.

As a gatekeeper for direct access to the health delivery system, the Doctor of Chiropractic’s responsibilities as a primary care clinician include wellness promotion, health assessment, diagnosis and the chiropractic management of the patient’s health care needs. 

When indicated, the Doctor of Chiropractic consults with, co-manages, or refers to other health care providers. In fact, chiropractors, medical doctors, physical therapists and other health care professionals now work as partners in occupational health, sports medicine, and a wide variety of other rehabilitation practices.

Information sources: The Council on Chiropractic Education (CCE) — http://www.cce-usa.org … and … the Association of Chiropractic Colleges (ACC) — http://www.chirocolleges.org

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3. What are the educational requirements to become a Doctor of Chiropractic?

Chiropractic professional education provides core knowledge in the basic and clinical sciences and related health subjects sufficient for the Doctor of Chiropractic to perform the professional obligations of a primary care clinician.

There are currently 16 chiropractic colleges in the United States. Since 1974, the standards for chiropractic education have been established and monitored by the Council on Chiropractic Education (CCE), a nonprofit organization located in Scottsdale, Arizona. The CCE is recognized by the U.S. Department of Education as the specialized accrediting agency for chiropractic education — setting the standards for the curriculum, faculty and staff, facilities, patient care and research.

Admissions requirements of chiropractic colleges are influenced by CCE standards and chiropractic licensing board requirements. A minimum of two years of undergraduate education is required before entering the chiropractic college, with successful completion of courses in biology, general chemistry, organic chemistry, physics, psychology, English/communication and the humanities. The chiropractic college curriculum generally spans four to five years, with no less than 4,200 hours of classroom, laboratory and clinical experience. Course offerings address at least the following subjects:

Information source: The Council on Chiropractic Education (CCE) — http://www.cce-usa.org

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4. What credentials are required of a Doctor of Chiropractic?

The practice of chiropractic is licensed and regulated in all 50 states in the U.S. and in over 30 countries worldwide. State licensing boards regulate, among other factors, the education, experience and moral character of candidates for licensure, and protect the public health, safety and welfare. In general, certain common criteria cross jurisdictional borders. These include:

• Pre-chiropractic education - States may require a minimum of two years in an accredited undergraduate program, which includes a prescribed science content (biology, zoology, general or inorganic chemistry, and related laboratories). An increasing number of U.S. states require a bachelor's degree of candidates for licensure. Most candidates enrolling in chiropractic college today have their bachelor's degrees, while some may achieve it through parallel programs offered by the chiropractic college.
  
  
• Graduation from an accredited chiropractic college - All chiropractic colleges in the United States are currently accredited by the Council on Chiropractic Education. Most licensure boards rely on the CCE to be certain the colleges meet both federal and professional educational standards for their programs, while several boards reserve the process of approving schools for the regulatory agency.
  
  
• Rigorous examinations - Most boards rely on a four-part examination offered by the National Board of Chiropractic Examiners (NBCE). This testing series covers basic sciences, clinical sciences, and clinical competency and practical skills. Boards may also require special examinations to be successfully completed by practitioners relocating from another jurisdiction, or those under review for disciplinary or impairment reasons.
  
  
• Background investigation – Licensure boards conduct a thorough investigation into the character and credentials history for each applicant for licensure.
  
  
• Understanding of state law - This is often called the jurisprudence portion of the board's assessment of the candidate. This is important because there are some differences among jurisdictions in the type of care a chiropractor may legally provide.

Information source: The Federation of Chiropractic Licensing Boards (FCLB) — http://www.fclb.org

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5. What can I expect from a Doctor of Chiropractic?

While the core concept of practice is based on healing without drugs or surgery, the specific scope may vary according to the laws of a specific jurisdiction. However, patients may commonly expect:

• A thorough physical examination to determine conditions which may be appropriate for chiropractic care;
  
  
• To be referred to another health care provider for conditions which are not appropriate for chiropractic care;
  
  
• To understand the type of care to be administered, and what results may be expected; (Click here for more information about chiropractic care.)
  
  
• Discussion with the doctor as the care continues, to evaluate both treatment effectiveness and projected duration;
  
  
• A clear understanding of financial arrangements;
  
  
• Appropriate, ethical care delivered in confidence, with respect for privacy and dignity.

Information source: The Federation of Chiropractic Licensing Boards (FCLB) — http://www.fclb.org

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6. What is being done in the area of Chiropractic research?

The scope of chiropractic research parallels that of medical research. Specifically, chiropractic researchers are actively involved in each of the following areas: basic science, education, outcomes research, health services, and clinical research. 

Research in chiropractic has been funded largely from within the profession with a significant portion coming from chiropractic college tuition dollars. National professional organizations (the American Chiropractic Association and the International Chiropractic Association) and State chiropractic associations have also given financial support to chiropractic research. 

Until recently, Federal funding has been almost nonexistent. In 1991, a federally-commissioned study conducted by the Corporate Health Policy Group reported that there was an "inherent bias" in favor of medical researchers when competing with chiropractors for Federal grants because of the superior research track record of medical researchers (Keating, 1992). Nonetheless, a small number of Federal grants recently have been awarded to projects involving chiropractic.

The following describes the major sources of funds for chiropractic research since 1990 and the types of studies that have been funded:

1. Chiropractic-Related Sources of Funding

· The Consortium for Chiropractic Research (CCR)

The Consortium for Chiropractic Research, established in 1989, is an organization composed of the 16 U.S. chiropractic colleges accredited by the Council on Chiropractic Education (CCE), and associate members who conduct or fund research. It is the largest single organized body of institutions dedicated to chiropractic research (CCR, 1995). Since 1990, CCR has awarded more than $660,000 to support four projects: the appropriateness of spinal manipulation of the cervical spine, the role of chiropractic in meeting rural health care needs, and randomized trials of the effect of chiropractic on chronic neck pain and childhood asthma.

· The Foundation for the Advancement of Chiropractic Education (FACE)

In 1981, Dr. William Harris, a chiropractor in private practice, established the Foundation for the Advancement of Chiropractic Education (FACE), a not-for-profit organization that has contributed more than $3 million to chiropractic research. In addition to funding research projects, FACE has provided funds to build research infrastructure at several chiropractic colleges and has contributed large sums to support research through the Foundation for Chiropractic Education and Research (FCER) and the National Institute of Chiropractic Research (NICR).

· Foundation for Chiropractic Education and Research (FCER)

The Foundation for Chiropractic Education and Research, established in 1967, had become the largest organization funding chiropractic research by 1992 (Keating, 1992). In 1990 the annual budget of FCER was about $2 million (Keating, 1990). Between 1990 and 1995, FCER has independently or jointly awarded approximately $3.7 million to more than 25 projects. During this time period, FCER has also awarded educational grants totaling $277,000 to 34 individuals, fulfilling one part of its mission (Peterson, 1995). The projects funded by FCER include a national study of the use of chiropractic services and evaluations of the effect of chiropractic care on back and neck problems, headaches, idiopathic scoliosis, asthma, dysmenorrhea, hypertension, and colic.

· National Chiropractic Mutual Insurance Company (NCMIC)

The National Chiropractic Mutual Insurance Company and FCER have co-funded more than 14 studies of the effect of chiropractic care on clinical problems such as dysmenorrhea, carpal tunnel syndrome, hypertension, and otitis media. Other jointly funded projects include studies of the role of chiropractors as primary care gatekeepers and analysis of referral patterns. They have also funded an effort to develop plans for an infrastructure to support a multidisciplinary practice-based research network. In total, FCER and NCMIC have jointly awarded almost $2 million in grants. On its own, NCMIC has awarded a grant to study the complications of chiropractic care.

· Lincoln College Education and Research Fund, Inc. (LCERF)

A non-profit corporation dedicated to the advancement of chiropractic science, the Lincoln College Education and Research Fund, Inc., was established in 1979. Funding research and educational pursuits, it has donated more than $250,000 toward establishing an eminent scholar chair at Florida State University in the College of Human Sciences. The LCERF has also funded various scholarships.

· National Institute of Chiropractic Research (NICR)

The National Institute of Chiropractic Research was established in 1987 as a non-profit corporation that conducts and supports chiropractic research (CCR, 1995). Founded by Dr. Arlan Fuhr, a chiropractor in private practice, the NICR is the only organization with an ongoing grant mechanism to fund chiropractic historical research. The NICR has awarded more than $325,000 to projects studying kinematic assessments of vertebral subluxation adjustments and leg length inequalities, cervical function measures, and others. The NICR has also supported research education and has jointly funded three studies with the FACE. Totaling almost $400,000, these studies have addressed kinematic methods to assess neck injury, biomechanics of the human spine, and outcome measures for cervical spine patients.

2. Federal Sources of Funding:

· The Agency for Health Care Policy and Research (AHCPR)

In 1993, the Federal Agency for Health Care Policy and Research awarded $980,000 to Group Health Cooperative of Puget Sound for a randomized trial comparing chiropractic, McKenzie physical therapy, and an educational booklet for low back problems. More recently, the AHCPR awarded UCLA $1.8 million to compare chiropractic, physical therapy, and usual medical care for low back pain. This project has involved collaboration with the Los Angeles College of Chiropractic. AHCPR also awarded a grant to the University of North Carolina to compare the costs and outcomes of the care for low back pain provided by primary care physicians, orthopedic surgeons, and chiropractors (Carey, 1995).

· Other Federal Agencies

The Health Resource and Services Agency (HRSA) funded three projects studying biomechanics of flexion-distraction therapy, manual therapy in the management of low back pain syndromes with myofascial and articular dysfunction, and low back pain practice activities and patient outcomes. These projects totaled more than $2 million. The Veterans Administration (VA) awarded a contract for the study of the biomechanics of cervical diagnostic maneuvers.

Information source: “Chiropractic in the U.S.: Training, Practice, and Research” – a project supported by grant number HS07915 from the Agency for Health Care Policy and Research – Pub. No. 98-N002 December 1997.

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