Areas of Weakness
A few aspects of professional development that chiropractic lacks that need to change are entrance examinations as well as obtaining a bachelor degree prior to matriculation. Even though most schools offer completion of the bachelor degree during the first two years of the program, there are a large amount of DC's that do not obtain this level of a degree in their career. They obtain a DC degree and that is it. Obtaining a bachelors would prepare students in a manner similar to medical students and weed out the less professional students, adding depth to the entering graduate students. Entrance exams would weed out the not-so-serious folks that tend to migrate to the DC path because these exams make it harder to get in. The MCAT or even the GRE would be great ways to see where students are in their academic abilities prior to matriculating into graduate school.
Another shortfall in the DC profession is there are only a couple residency programs available for postdoctorate training. The most respected residency program in chiropractic is the radiology program. Furthering education in this residency leads to a Diplomate in Radiology, also known as the DACBR (Diplomate of American Chiropractic Board of Radiology). There are many DACBR's that work in imaging centers in the US and they are respected as equivalent to their MD/DO counterparts. Iconic figures such as Terry Yochum and Lindsay Rowe, established DC's as experts in musculoskeletal disease and their numerous textbooks are used in many medical schools nationwide.
The lack of a residency for DC grads puts new doctors at risk of making mistakes with diagnostics. Medical malpractice claims are largely due to either missing something critical in a patient's diagnosis or missing something on a radiograph taken in the DC's office. Treating a complaint that is not musculoskeletal in nature as a musculoskeletal problem, is a real problem in our profession. Many schools do not train students in primary care disease recognition and this leads to mis-diagnosis. On the contrary, in allopathic medicine, the mis-management of musculoskeletal disease is common place because of the lack of training in manual medicine. However, allopathic training is much more expansive and thorough after the MD or DO degree has been earned during the residency.
Physical therapy is chiropractic's greatest competitor. Though their training does not qualify them as physicians, their training these days is nearly identical to the chiropractic education in the musculoskeletal realm. Many DPT's are skilled in adjusting the spine and extremities and they have greater knowledge in strength training and cardiovascular training. There are further post-doctorate training programs which essentially extend their 3 year program to 4 or 5 total years of training. Chiropractors, on the other hand, have much more training in nutrition and lifestyle modification than any other profession and they are trained to manage general health conditions conservatively without pharmaceuticals, which is by far, the greatest achievement and strength of the profession.
Counterproductive Roots
Adherence to the subluxation theory (i.e., pinched nerves lead to disease) gets many, many DC's into trouble. They convince the public that they do not need medical interventions when a team approach is really the best method these days. DC's constantly overstep the boundary of primary care physician by treating all problems with spinal adjustments and claiming these "subluxations", once cured, will allow the body to heal itself. It is ludicrous to think this way. Evidence must be in place to sell such a risky approach to total patient care. As stated previously, a team approach is needed these days and DC's should focus their work on musculoskeletal care and fitness and let MD's and DO's work in medicine. That being said, DC's are required by law to order blood labs to help rule in/out or screen for disease. The issue comes down to management. If DC's manage diseases such as, hypertension, diabetes or cancer with spinal adjusting, they are mismanaging the patient's care and doing the profession and the patient a disservice. An alternative approach would be to manage conditions with nutritional therapeutics and relieve physical stress with regular adjusting and physical therapeutics. The problem revolves around deception. False claims can and do get DC's into trouble. We must be logical.
Rationale for Chiropractic Medicine
Discounting the utility of chiropractic care is not the best mindset to have. Chiropractors do great work throughout the nation everyday. They are respected by their patients and have made great strides in their professional development during the past 20 or more years. Research is showing that regular chiropractic care can reduce musculoskeletal degeneration and even perhaps reduce the allostatic load (i.e., accumulated physical stress on bodily systems) leading to a stronger immune system and greater quality of life. Add proper nutritional and daily physical activity and you have a recipe for a high quality of life and less risk for dependence on pharmaceuticals later in life.
We are in a great position to be true wellness providers. We have the training to analyze blood panels and monitor change while implementing nutritional changes. In the allopathic world, doctors do this but it is rare to find one that does anything to prevent the use of pharmaceuticals. It is as if they wait until there is a need for drugs or surgery to do anything about the condition. This is where DC's and MD's differ in thought. MD's do not practice prevention like DC's do. Mainly because it is very difficult to show immediate benefits of prevention. Drugs are immediate and are very profitable and useful for severe conditions, but using them as permanent solutions to problems caused by lifestyle, crosses an ethical boundary.
I love thinking like this, "Hyperlipidemia is not due to a lack of Lipitor in the system, and gout is not due to a lack of Aloprim in the system, however, both are lifestyle issues and largely non-profitable if controlled conservatively." If profit is a concern, we should develop programs that make us money that are in the best interest of the patient, like fitness and nutrition coaching and training.
Rationale for Chiropractic Medicine
Discounting the utility of chiropractic care is not the best mindset to have. Chiropractors do great work throughout the nation everyday. They are respected by their patients and have made great strides in their professional development during the past 20 or more years. Research is showing that regular chiropractic care can reduce musculoskeletal degeneration and even perhaps reduce the allostatic load (i.e., accumulated physical stress on bodily systems) leading to a stronger immune system and greater quality of life. Add proper nutritional and daily physical activity and you have a recipe for a high quality of life and less risk for dependence on pharmaceuticals later in life.
We are in a great position to be true wellness providers. We have the training to analyze blood panels and monitor change while implementing nutritional changes. In the allopathic world, doctors do this but it is rare to find one that does anything to prevent the use of pharmaceuticals. It is as if they wait until there is a need for drugs or surgery to do anything about the condition. This is where DC's and MD's differ in thought. MD's do not practice prevention like DC's do. Mainly because it is very difficult to show immediate benefits of prevention. Drugs are immediate and are very profitable and useful for severe conditions, but using them as permanent solutions to problems caused by lifestyle, crosses an ethical boundary.
I love thinking like this, "Hyperlipidemia is not due to a lack of Lipitor in the system, and gout is not due to a lack of Aloprim in the system, however, both are lifestyle issues and largely non-profitable if controlled conservatively." If profit is a concern, we should develop programs that make us money that are in the best interest of the patient, like fitness and nutrition coaching and training.
