The Changing Profession: 2020 NBCE Practice Analysis
Editorial Staff
| DIGITAL EXCLUSIVE
While it may not seem like it, the chiropractic profession in the U.S. is changing. Some changes are subtle in nature; others are not. Practice Analysis of Chiropractic 2020, produced by the National Board of Chiropractic Examiners, is the most recent effort to identify those changes.
Today's DC is definitely not the same as 30 years ago. In 1991, women made up only 13.3% of DCs. Now, women make up almost one-third (31.8%), and are the majority (53.2%) of DCs under age 30. Over that same period, the percentage of DCs with bachelor's, master's or doctoral degrees (exclusive of the DC degree) has grown from half (53.7%) to over 80%, with almost all (95.4%) DCs under age 40 having at least one.
Cash is king, with over a third (36.3%) of chiropractic cases paid with private pay or cash. Only a quarter (25.4%) are paid through insurance (non-managed care), with Medicare/Medicaid at 14.3% and managed care at 9.3%.
Twenty-eight percent of DCs provide care to our military, a huge jump from 6.7% just five years prior. Almost two-thirds (65%) of doctors focus on wellness and maintenance care. Other popular areas of focus are orthopedics / injuries (39.5%), care of athletes (39.4%), pediatrics (38.8%), rehabilitation (37.9%) and nutritional recommendations (33.3%).
Almost half of DCs (44.1%) read peer-reviewed research at least weekly; 13.7% at least daily. Consequently, almost one-third (30.6%) provide research-based treatment several times daily, and over half (51.1%) do so at least weekly.
For the first time, the analysis provides data on DCs who practice part-time (less than 20 hours a week) and those who do not currently practice. Non-practicing DCs tend to be male (63.8%) and 60 years or older (46%). Part-timers are slightly more likely to be male (52.2%) and 60 years or older (37%). Almost one-fifth of part-timers (18.9%) are homemakers; 16.7% work as faculty members.
Non-practicing doctors tend to be retired (36.7%), with 14.9% working as faculty members of chiropractic and non-chiropractic institutions. Less than one-third of those not practicing (32.2%) have actually left the profession.
Because they have yet to pass national legislation protecting the chiropractic profession, Japanese DCs are in a similar situation that U.S. DCs faced. We were fortunate enough to be able to pass chiropractic licensure state by state. The DCs in Japan must accomplish this nationally, which has proved to be an extremely difficult task. And in spite of their efforts, Japanese DCs are currently faced with two chiropractic professions.
This article focuses on nine severe injuries that are generally not diagnosable until the third to fourth week following the date of injury, including how to diagnose these severe injuries. The discovery of any of these injuries early can make a significant difference in the case outcome.
Recently, I taught a 12-hour whiplash class to a group of chiropractors for continuing education. I taught that performing O’Donoghue’s maneuver enabled the providers to differentiate cervical strain from sprain. To my surprise, one of the attendees stated that it is not possible to diagnose a cervical strain and sprain with a whiplashed patient using O’Donoghue’s maneuver.
