U.S.
GOVERNMENT AGENCY REPORT (return)
A 1994 study published by the U.S. Agency for Health Care Policy and
Research (AHCPR) and the U.S. Department of Health and Human Services
endorses spinal manipulation for acute low back pain in adults in
its Clinical Practice Guideline # 14. An independent multidisciplinary
panel of private-sector clinicians and other experts convened and
developed specific statements on appropriate health care of acute
low back problems in adults. One statement cited, relief of discomfort
(low back pain) can be accomplished most safely with spinal manipulation,
and/or nonprescription medication.
THE
MANGA REPORT (return)
A major study to assess the most appropriate use of available health
care resources was reported in 1993. This was an outcomes study funded
by the Ontario Ministry of Health and conducted in hopes of sharing
information about ways to reduce the incidence of work related injuries
and to address cost-effective ways to rehabilitate disabled and injured
workers. The study was conducted by three health economists led by
University of Ottawa Professor Pran Manga, Ph.D. The report of the
study is commonly called the Manga Report. The Manga Report overwhelmingly
supported the efficacy, safety, scientific validity, and cost-effectiveness
of chiropractic for low-back pain. Additionally, it found that higher
patient satisfaction levels were associated with chiropractic care
than with medical treatment alternatives. "Evidence from Canada
and other countries suggests potential savings of hundreds of millions
annually," the Manga Report states. "The literature clearly
and consistently shows that the major savings from chiropractic management
come from fewer and lower costs of auxiliary services, fewer hospitalizations,
and a highly significant reduction in chronic problems, as well as
in levels and duration of disability."
RAND
STUDY ON LOW-BACK PAIN (return)
A four-phase study conducted in the early 1990s by RAND, one of America's
most prestigious centers for research in public policy, science and
technology, explored many indications of low-back pain. In the RAND
studies, an expert panel of researchers, including medical doctors
and doctors of chiropractic, found that:
FLORIDA
WORKERS' COMPENSATION STUDY (return)
A 1988 study of 10,652 Florida workers' compensation cases was conducted
by Steve Wolk, Ph.D., and reported by the Foundation for Chiropractic
Education and Research. It was concluded that "a claimant with
a back related injury, when initially treated by a chiropractor versus
a medical doctor, is less likely to become temporarily disabled, or
if disabled, remains disabled for a shorter period of time; and claimants
treated by medical doctors were hospitalized at a much higher rate
than claimants treated by chiropractors."
WASHINGTON
HMO STUDY (return)
In 1989, a survey administered by Daniel C. Cherkin, Ph.D., and Frederick
A. MacComack, Ph.D., concluded that patients receiving care from health
maintenance organizations (HMOs) within the state of Washington were
three times as likely to report satisfaction with care from chiropractors
as they were with care from other physicians. The patients were also
more likely to believe that their chiropractor was concerned about
them.
UTAH
WORKERS' COMPENSATION STUDY (return)
A workers' compensation study conducted in Utah by Kelly B. Jarvis,
D.C., Reed B. Phillips, D.C., Ph.D., and Elliot K. Morris, JD, MBA,
compared the cost of chiro practic care to the costs of medical care
for conditions with identical diagnostic codes. Results were reported
in the August 1991 Journal of Occupational Medicine. The study indicated
that costs were significantly higher for medical claims than for chiropractic
claims; in addition, the number of work days lost was nearly ten times
higher for those who received medical care instead of chiropractic
care.
PATIENT
DISABILITY COMPARISON (return)
A 1992 article in the Journal of Family Practice reported a study
by D.C. Cherkin, Ph.D., which compared patients of family physicians
and of chiropractors. The article stated "the number of days
of disability for patients seen by family physicians was significantly
higher (mean 39.7) than for patients managed by chiropractors (mean
10.8)." A related editorial in the same issue referred to risks
of complications from lumbar manipulation as being "very low."
OREGON
WORKERS' COMPENSATION STUDY (return)
A 1991 report on a workers' compensation study conducted in Oregon
by Joanne Nyiendo, Ph.D.. concluded that the median time loss days
(per case) for comparable injuries was 9.0 for patients receiving
treatment by a doctor of chiropractic and 11.5 for treatment by a
medical doctor.
STANO
COST COMPARISON STUDY (return)
A study by Miron Stano, Ph.D., reported in the June 1993 Journal of
Manipulative and Physiological Therapeutics involved 395,641 patients
with neuromusculoskeletal conditions. Results over a two-year period
showed that patients who received chiropractic care incurred significantly
lower health care costs than did patients treated solely by medical
or osteopathic physicians.
SASKATCHEWAN
CLINICAL RESEARCH (return)
Following a 1993 study, researchers J. David Cassidy, D.C., Hayrno
Thiel, D.C., M.S., and W. Kirkaldy-Willis, M.D., of the Back Pain
Clinic at the Royal University Hospital in Saskatchewan concluded
that "the treatment of lumbar intervertebral disk herniation
by side posture manipulation is both safe and effective."
WIGHT
STUDY ON RECURRING HEADACHES (return)
A 1978 study conducted by J.S. Wight, D.C., and reported in the ACA
Journal of Chiropractic, indicated that 74.6% of patients with recurring
headaches, including migraines, were either cured or experienced reduced
headache sym tomatology after receiving chiropractic manipulaption.
1991
GALLUP POLL (return)
A 1991 demographic poll conducted by the Gallup Organization revealed
that 90% of chiropractic patients felt their treatment was effective;
more than 80% were satisfied with that treatment; and nearly 75% felt
most of their expectations had been met during their chiropractic
visits.
1990
BRITISH MEDICAL JOURNAL REPORT (return)
A study conducted by T.W. Meade, a medical doctor, and reported in
the June 2, 1990, British Medical Journal concluded after two years
of patient monitoring, "for patients with low-back pain in whom
manipulation is not contraindicated, chiropractic almost certainly
confers worthwhile, long-term benefit in comparison with hospital
outpatient management."
VIRGINIA
COMPARATIVE STUDY (return)
A 1992 study conducted by L.G. Schifrin, Ph.D., provided an economic
assessment of mandated health insurance coverage for chiropractic
treatment within the Commonwealth of Virginia. As reported by the
College of William and Mary, and the Medical College of Virginia,
the study indicated that chiropractic provides therapeutic benefits
at economical costs. The report also recommended that chiropractic
be a widely available form of health care.
1992
AMERICA HEALTH POLICY REPORT (return)
A 1992 review of data from over 2,000,000 users of chiropractic care
in the U.S., reported in the Journal of American Health Policy, stated
that "chiropractic users tend to have substantially lower total
health care costs," and "chiropractic care reduces the use
of both physician and hospital care."
1985
UNIVERSITY OF SASKATCHEWAN STUDY (return)
In 1985 the University of Saskatchewan conducted a study of 283 patients
"who had not responded to previous conservative or operative
treatment and who were initially classified as totally disabled. The
study revealed that "81% ... became symptom free or achieved
a state of mild intermittent pain with no work restrictions"
after daily spinal manipulations were administered.
LANDMARK
LEGAL DECISION SUPPORTS CHIROPRACTIC (return)
Further validation of chiropractic care evolved from an antitrust
suit which was filed by four members of the chiropractic profession
against the American Medical Association (AMA) and a number of other
health care organizations in the U.S. (Wilk et al v. AMA et al, 1990).
Following
11 years of litigation, a federal appellate court judge upheld a ruling
by U.S. District Court Judge Susan Getzendanner that the AMA had engaged
in a "lengthy, systematic, successful and unlawful boycott designed
to restrict cooperation between MDs and chiropractors in order to
eliminate the profession of chiropractic as a competitor in the U.S.
health care system.
Judge Getzendanner rejected the AMA's patient care defense, and cited
scientific studies which implied that "chiropractic care was
twice as effective as medical care in relieving many painful conditions
of the neck and back as well as related musculo- skeletal problems."
Since the court's findings and conclusions were released, an increasing
number of medical doctors, hospitals, and health care organizations
in the U.S. have begun to include the services of chiropractors.
TESTING,
ACADEMIC AND PROFESSIONAL REQUIREMENTS (return)
In order to become a licensed doctor of chiropractic, an individual
must meet stringent testing, academic and professional requirements.
Currently, an individual must complete the four major steps shown
below in order to become a chiropractic practitioner:
- Complete
required general college-level studies - Bachelor's degree
required by some state
- Obtain
a Doctor of Chiropractic degree and complete clinical externship
through an accredited four-year chiropractic college program
- Pass
required National Board or other exams
- Meet
individual state requirements for licensure
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CHIROPRACTIC
TRAINING (return)
Government inquiries (some of which are described in this brochure),
as well as independent investigations by medical practitioners, have
affirmed that today's chiropractic academic training is of equivalent
standard to medical training in all pre-clinical subjects. High standards
in chiropractic education are maintained by the Council on Chiropractic
Education (CCE) and its Commission on Accreditation, as recognized
by the U.S. Department of Education. Some Chiropractic colleges require
a Bachelor's degree before enrollment. A doctor of chiropractic's
training generally requires a minimum of six years of college study
(two years of which are undergraduate course work) and an internship
prior to entering practice. Postdoctoral training in a variety of
clinical disciplines and specialties is also available through accredited
colleges and specialty councils.
CHIROPRACTIC
LICENSING (return)
Chiropractic is one of many occupations which are regu lated by state
licensing agencies. The requirements for chiropractic license vary
from state to state (and country to country). Some states require
a Bachelor's degree as a prerequisite for licensure. To assist the
various regulatory agencies in assessing candidates for licensure,
the National Board administers examinations to individuals currently
in the chiropractic educational system or who have completed a chiropractic
educational program. The National Board also offers an examination
designed for previously licensed individuals. A candidate for chiropractic
licensure may request that transcripts of scores from National Board
examinations be forwarded to licensing agencies which assess eligibility
for licensure. Scores from National Board examinations are made available
to licensing agencies throughout the U.S. and in some foreign countries
including Canada, the United Kingdom, France and Australia.
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Information
Provided by The National Board of Chiropractic Examiners
901
54th Ave. • Greeley, Co 80634
970-356-9100
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