This is the age-old question that continues to evolve as healthcare evolves. Ask any of my patients and they will tell you Dr. White jokes about not being a “real doctor”. Is this what I believe? Obviously not, but I’ve brushed off the nasty stereotypes about the chiropractic profession and have developed my own light hearted way of approaching this question.
Chiropractors are “doctors” and hold a doctorate degree (DC) requiring eight years of schooling after graduating high school. Most states list chiropractors in their state laws under the term “physician” or “chiropractic physician”, and most chiropractic physicians have a much larger scope of practice than you will ever see in their professional settings.
So why have chiropractic physicians been mocked and ridiculed for so many years by other healthcare providers, governing boards, and even the general public? Trust me this is a question I face daily and here are some of the best answers I have found over my decade of being in practice.
Overall lack of understanding
As the old saying goes, “you don’t know what you don’t know.” I have found this to mostly be the case when I ask patients, other doctors, and even friends if they know what chiropractors do. Very few understand what chiropractors do or can articulate it in a way that doesn’t sound quacky even to my ears. “They crack backs.” “They re-align the spine.” or my favorite “I don’t really know, but I feel like I need one.” That last one instills a lot of blind trust in me and our practice but also shows that we have done a horrible job of educating the public as to our capabilities.
Many people are astonished that I went to a 4-year university and have pre-medical degree as well as another 4 years of chiropractic school. They are even more caught off guard when I explain to them that the first 2 years of medical school and first 2 years of chiropractic school are essentially identical. If you look at the image below you will see we have similar course loads when it comes to the didactic learning.
https://biology.uni.edu/sites/default/files/chiropractic_education_vs_medical_education.pdf
Lack of science
This is probably the second biggest reason chiropractors are laughed at. This was once true.
Chiropractors were once notorious for outrageous claims of curing many medical conditions by simply manipulating the spine or associated joints with no sound proof other than anecdotal experiences. This is why “many doctors hate chiropractors.” Healthcare as we know it circulates around sound scientific evidence obtained through randomized peer-reviewed studies and until the mid 1980’s very few of these studies existed for chiropractic medicine. There are now thousands of studies funded and researched by reputable medical schools and chiropractic universities. Many of these studies have even been published in “strict medical” journals like JAMA, Pain Medicine, The Lancet, and Spine.
Inconsistent practice and treatments
If you have a doctor that claims he can waive a crystal over your spine and cure your diabetes I would tell you to run. This is a true claim by a chiropractor I know. How could a profession gain any kind of respect or validation from other healthcare professionals and a very skeptical general public with egregious claims like these? Slowly we are being reigned in from being the mavericks we once were but this has taken time and collaboration of new chiropractic physicians focused on bridging gaps and joining the world of science and leaving the world of snake oils. When my patients indicate they are nervous about coming to a chiropractor, my immediate response is “don’t worry I’m not one of those quacky chiropractors, in fact I am probably the most medically minded chiropractor you will meet.” The fact that I have to tell them this means we have a long way to go still.
No diagnosis
As Peter Griffin would say, “this really grinds my gears.” Why would you spend $200k to receive a
degree that gives you the authority and comprehensive education to properly diagnose any and all medical conditions then not diagnose? Our practice is entirely referral based because we take the time to diagnose what other chiropractors and health care providers wont. All too often patients are receiving treatment elsewhere without ever knowing what their medical condition is. This creates confusion for the patient as well as their other health care providers. I always joke that my license and education allow me to diagnose anything from a hangnail to malignant cancers, but typically I stick to my lane.
Chiropractors try to do too much
There is a reason that there are multiple specialties in the medical profession. It’s because medicine is so highly complex that no single person possesses the knowledge to cure all medical ailments. So why do chiropractors try to fix every condition? Google lists some of the most commonly asked questions about chiropractors “can a chiropractor write a prescription?” In some states chiropractors can write prescriptions which I expect will continue to become more accepted across state boards as the need for primary care providers grows. We certainly have a lot of the required education including pharmacology, pharmacokinetics and pathology, but ongoing certification and training is a must if this is to happen. Chiropractors need stop waiving supplements and herbs around like they are miracle drugs and refer to the appropriate medical providers when complex systemic conditions present to their clinics.
When chiropractors refuse to refer to more specialized providers, we tend to see questions like, “has a chiropractor ever killed someone?”. The answer is “yes” and if you read the malpractice claims and lawsuits, it is typically due to negligence and/or stepping outside of their scope. I have had two patients present to my office with active CVA (cerebrovascular accident or stroke.) Had I not taken the time to assess the patient properly, I most certainly would have been their cause of death, but both patients were immediately rushed to the ER because that is what our training has taught us. I have found multiple myeloma, malignant melanomas, lupus, osteosarcoma, and a plethora of other diseases that were missed by other providers and these patients are always referred to the appropriate medical specialist. When we “stay in our lane” addressing neuromusculoskeletal conditions and provide treatments backed by peer reviewed studies we gain the respect of other providers and a public that is
far more educated than ever before.
So, when I am asked, “are chiropractors real doctors?” I typically respond yes, but only if they act like “real doctors.”