Answer: When such a referral can improve the health of a patient.
How often is that? More often than you might think. Approximately 10 million Americans were treated by chiropractors last year. Many chose to see a chiropractor based on their own decisions, but some were referred by their family doctors for treatment of a problem that may not have responded favorably to drug therapy, hospitalization - even surgery. The chiropractic physician has been trained to discern when there is a structural, biomechanical or neuromusculoskeletal problem. Chiropractors use manual manipulation of the spine and associated muscle, as well as, physiologic therapeutics (electrical stimulation, Ultrasound, diathermy, cryotherapy) and exercise.
More specifically, the chiropractic physician can complement the treatment of the medical physician in many conditions, e.g., bursitis, tendonitis neuralgia, strain, sprain, non-surgical disc problems and functional spinal disorders.
In fact, there is no inherent reason why chiropractors and medical doctors should not work together. Through referral or patient co-management, another dimension is added to patient care.
lnterprofessional cooperation results in several worthwhile accomplishments – the more rapid recovery of the patient, the elevation of both doctors in the esteem of the patient, a more fruitful reciprocal interprofessional relationship between participating physicians, and a better understanding of how each discipline can support the other in the effort for improved public health.
· After two years of pre-chiropractic college work, chiropractic colleges require a minimum of four academic years of professional resident study (not less than 4,200 clock hours), including clinical experience under strict supervision. For a major part of two years, the chiropractic student is educated in anatomy, biochemistry, micro-biology, pathology, physiology, public health, diagnosis and x-ray, clinical disciplines, related health sciences, and chiropractic principles and practice. The remaining two years are devoted to practical or clinical studies dealing with the diagnosis and treatment of disease with approximately half of the time spent in the clinic.
· To obtain the degree Doctor of Chiropractic, a candidate must have a minimum of two years pre-professional college education with a prescribed content plus four years of resident instruction at a chiropractic college.
· Candidates for a chiropractic license must qualify under equivalent basic science examinations as those required for M.D.s.
· Most of the state chiropractic examining boards require an applicant for licensure examination to be a graduate from a chiropractic college having status with an agency recognized by the United States Department of Education.
· The U.S. Department of Education officially recognizes the Council on Chiropractic Education (CCE), as the accrediting agency for chiropractic colleges. The CC, in addition, is also a member of the Council of Post-Secondary Accreditation (COPA).
· STANDARD BASIC CURRICULUM
o Phase I-Basic Science Subjects
(46%, 1,840 hours)
· Anatomy-includes gross anatomy, embryology, and histology, with particular emphasis on neurology.
· Physiology-includes physiology of blood and lymph, circulation, respiration, excretion, digestion, metabolism, endocrinology, special senses, and nervous system.
· Chemistry (inorganic, organic, biochemistry, and nutrition)-includes physical chemistry offoods, digestion and metabolism. Nutrition to include processing of foods and dietetics as applied to health and disease.
· Pathology-includes general and special pathology; Bacteriology-includes parasitology and serology.
· Hygiene, Sanitation, and Public Healthincludes sanitation and hygienic procedures and regulations, as well as the prevention of disease.
o Phase II-Clinical Science Subjects (521ft, 2,080 hours)
· Physical, Clinical, Laboratory, and Differential Diagnosis.
· Gynecology, Obstetrics, and Pediatrics.
· Roentgenology, technique and interpretation.
· Geriatrics, Dermatology, Syphilology, Toxicology, Psychology, and Psychiatry.
· Principles of Chiropractic - includes spinal analysis, adjustive techniques, orthopedics, and first aid.
· Jurisprudence, Ethics, and Economics.
Required administrative electives (2%, 80 hours) include such courses that may be selected by the college to be a part of the regular curriculum. In addition, 200 or more hours in optional administrative electives are required. Thus, the minimum grand total is 4,200 hours.
· Upon graduation from chiropractic college, prospective practitioners must pass standard examinations in order to be licensed by the state. To maintain the high standards of the profession, most states have annual continuing educational requirements to retain licensure.
· Federal Authorization and Recognition
o As it Applies for All Americans
§ Vocational Rehabilitation program
§ Under the International Revenue Code, chiropractic care is a “medical” deduction
o As it Applies Specifically for Federal Employees
§ In Federal employee worker’s compensation
§ In Postmasters benefit program
§ In Mail Handlers benefit program
§ In leave approvals for civil service excuse of illness
o As it Applies Specifically for Veterans
§ GI Bill of Rights covers education in chiropractic colleges
· Health Planning
o Over 100 health systems agencies (HAS’s) have doctors of chiropractic elected and/or appointed as members of the HSA board of governors, as technical advisors, and sub-area council members.
o A number of D.C.’s have been elected and/or appointed to the important policy-making State Health Coordinating Councils (SHCC’s).
o Chiropractic manpower and technical information is included in over 75 health systems plans.
o The U.S. DHHS appointed a chiropractic physician to serve as a member of the Professional Review Standards Organization (PRSO).
o Under the immigration law, aliens are admitted as students in order to study in chiropractic colleges.
o The U.S. Public Health Service classifies doctors of chiropractic among "medical specialists and practitioners," includes D.C.’s in its Health Manpower Sourcebook, and includes a chapter covering chiropractic in Health Resources Statistics.
o The U.S. Department of Labor, Bureau of Labor Statistics, lists chiropractic in its Occupational Outlook Handbook.
o The Railroad Retirement Act includes chiropractic services.
o The Longshoremen's and Harbor Workers' Compensation Act includes chiropractic services.
o A chiropractic roentgenologist serves as a consultant to the Bureau of Radiological Health, National Institutes of Health (U.S. DHHS).
· Private Sector
o Virtually all major commercial health insurance carriers include chiropractic in their private policies.
o Major industrial employers (e.g., General Motors) have included chiropractic in their health plans for all their own employees.
o Substantial numbers of major international, national and local unions include chiropractic in their health and welfare plans (e.g., including the railroad and rubber unions).
· Chiropractic In Industry
o With the emphasis of the chiropractic profession in the areas of biomechanics, structure, and function, industry with its high percentage of injuries, mostly neuromusculoskeletal, are looking more and more to doctors of chiropractic as industrial consultants.
· Chiropractic In Sports
o Chiropractic is a natural addition to the sports arena, particularly with the attention of proper muscular tone and body mechanics. Many teams, local and national, employ D.C.’s as team doctors.
· State Licensing and Authorization
o All 50 states, plus the District of Columbia, U.S. Virgin Islands and Puerto Rico, recognize and license doctors of chiropractic as primary health care providers.
o All 50 states authorize chiropractic services as part of their workers' compensation programs.
· The Department of Health and Human Services classifies doctors of chiropractic as Category I health-care providers, such as MD’s, DO’s and DDS’s.