The National Board of Chiropractic Examiners (NBCE) has released its 2010 Practice Analysis of Chiropractic. In completing the survey, the NBCE contacted nearly 10,000 DCs from all 50 states; 2,371 chiropractors practicing at least 20 hours per week responded, providing data on 2009 practice trends.
The fourth such survey conducted by the NBCE, Practice Analysis includes data on various aspects of professional practice in the U.S., such as years in practice and average number of hours practiced per week; level of non-chiropractic education attained, including specialties; CE hours taken in the previous year; provision of adjunctive care; participation in hospitals and military health facilities; and frequency of patient referrals. Here are some of the other notable findings, particularly as they compare to survey results from previous years.
Patient Age
These figures are similar overall to the previous survey, conducted in 2003, except that as of 2009, DCs tend to see a slightly higher percentage of older (51 years and older) patients as compared to younger (30 years or younger) patients.
Referrals to Chiropractors
Compared to 2003, chiropractors reported receiving less referrals from other health care providers in several fields, such as physical therapy, family practice, nutrition and podiatry. However, they reported slightly more referrals from the acupuncture, massage therapy and pediatric communities. In both cases, changes were slight compared to 2003, and none of the referral patterns exceeded a description of "sometimes," meaning 1-3 referrals per month, except in the case of massage therapy.
Practice Components
Fairly significant differences are seen when comparing 2003 with 2009, particularly with regard to increased emphasis on business management and documentation. In 2009, 17.4% of practice focused on business management (compared to only 13.2% in 2003), while 25.2% focused on documentation (compared to 18.9% in 2003). These two areas of practice focus took time from direct patient care and patient education: 57.4% of practice in 2009 compared with 68.0% in 2003.
Practice Hours Per Week
Half of all chiropractors surveyed (49.8%) practice 30-39 hours a week, with another 20.9% working 20-29 hours and 24.4% working 40-49 hours. A small percentage (1.4%) work 60-plus hours a week. These figures are essentially the same as what was reported in 2003.
Many relevant diagnostic signs are not performed deliberately by the examiner or by the patient at the examiner’s direction. They are observed as the patient reacts to their condition. Fortin’s finger sign, Minor’s sign, and Vanzetti’s sign are three examples of this principle.
Spearheaded by burgeoning scientific and clinical research literature, psychedelics have reached a level of media coverage and popular interest that has not been seen for over half a century. By “psychedelics,” we are referring to the unique class of substances that includes psilocybin (the active compound found in so-called “magic mushrooms”), LSD, dimethyltryptamine (DMT), ayahuasca, 5-MeO-DMT, and mescaline – each of which occurs in the natural world (except for LSD, which is a semi-synthetic compound).
While working at the Lovelace Medical Center in Albuquerque, N.M., one of the primary care physicians stated that imaging every patient prior to receiving chiropractic was not medically necessary. It was at that point I reconsidered the need for the imaging of every patient to avoid malpractice.
