(D.C.) DOCTOR OF CHIROPRACTIC

• What is chiropractic?
• How are chiropractors educated?
• What can you tell me about Canadian Memorial Chiropractic College?
• How is chiropractic regulated?
• Is chiropractic treatment safe?

1. What is Chiropractic?

Chiropractic is one of the largest primary-contact health care professions in Canada with over 6,000 practicing chiropractors (2004). Approximately four and a half million Canadians use the services of a chiropractor each year (1).

Chiropractic is a regulated health profession recognized by statute in all Canadian provinces and American states. The benefits of chiropractic care are well recognized by other health practitioners. In a 1995 survey, 44 per cent of Ontario and Alberta physicians indicated that they refer patients for chiropractic treatment (2).

Chiropractic spinal manipulation (commonly referred to as a chiropractic adjustment) is a drug-free, non-invasive manual procedure which utilizes the highly-refined skills developed during four intensive years of chiropractic education. The primary goal of chiropractic manipulation is to treat areas of decreased movement in the joints of the body, particularly the spine, which can create a reaction in surrounding tissues (ligaments, muscles and nerves) resulting in pain, dysfunction and muscular spasm. Chiropractors assess disorders related to the spine, nervous system, and joints of the extremities and provide diagnosis, treatment and management of those disorders. Chiropractors are also trained to prescribe therapeutic exercise and other non-invasive therapies including nutritional counseling.

Spinal manipulation, as practiced by trained chiropractors, is a highly controlled procedure, which rarely causes discomfort. The chiropractor adapts the procedure to meet the specific needs of each patient. Patients often note positive changes in their symptoms immediately following treatment.

The vast majority of patients who seek chiropractic care do so for complaints of the musculoskeletal system, most often for conditions affecting the spine (3). Scientific study of spinal adjustment has clearly demonstrated that chiropractic treatment improves function and is effective for common conditions such as headache, and neck and back pain. Between 86 and 96 per cent of all visits to chiropractors are for these or similar conditions (3).

In many cases, such as acute lower back pain, chiropractic care may be the primary method of treatment. Where other medical conditions exist, chiropractic care may complement or support medical treatment by relieving the musculoskeletal aspects of discomfort associated with the condition. Chiropractic care may also be palliative, providing symptomatic relief to patients with chronic conditions.

(1) Miller W. Use of Alternative Health Care Practitioners by Canadians. Canadian Journal of Public Health. 1997.88(3):154-58.
(2) Verbeof MJ & Sutherland LR. Alternative Medicine and General Practitioners: Opinions and Behaviours. Canadian Family Physician. 1995. 41:1005-1011.
(3) Chiropractors: Do They Help?, Kelner M, Hall O, Coulter I, Toronto, Fitzhenry & Whiteside, 1980.Waalen DP et al. Demographic and Clinical Characteristics of Chiropractic Patients: A five year study of patients treated at the Canadian Memorial Chiropractic College. Journal of the Canadian Chiropractic Association. 1994. 38(2):75-82.

2. How Are Chiropractors Educated?

In Canada, chiropractors are educated through two programs offered at the Canadian Memorial Chiropractic College (CMCC) in Toronto, and at l'Université du Québec à Trois-Rivières (UQTR). Both programs are fully accredited by the Council on Chiropractic Education of Canada (CCEC) which has adopted standards similar to those of the Council on Chiropractic Education in the United States which is, in turn, recognized by the United States Department of Education.

Chiropractic students undergo a rigorous course of study similar to that of other health care professionals. Entrance requirements are also similar. Students are required to complete a minimum of three years of university before they are eligible for admission to the CMCC accredited program which requires four years of full-time study, including a year-long internship in the College's clinics.

In addition to the academic program, chiropractic education requires hands-on clinical experience under the direct supervision of highly-qualified chiropractic faculty. This experience includes clinical assessment, diagnosis, treatment, and referral protocols. The faculty at both CMCC and UQTR have diverse backgrounds and offer students a wide range of expertise. Faculty come from such disciplines as biological sciences, pathology, medicine and psychology, as well as chiropractic. Both the CMCC and the UQTR programs include courses in anatomy, biochemistry, physiology, neurology, embryology, principles of chiropractic, radiology (biophysics and protection to clinical x-ray interpretation and diagnosis), immunology, microbiology, pathology, nutrition, and clinical sciences specifically relating to diagnosis.

3. Information About Canadian Memorial Chiropractic College

The Canadian Memorial Chiropractic College has been a leader in chiropractic research for more than five decades. The College has dedicated itself to the development of an ongoing, productive research program. Faculty have been successful in obtaining research grants from funding agencies and have published extensively in peer-reviewed and refereed chiropractic journals, as well as in multi-disciplinary journals such as the British Medical Journal, Spine, Annals of Internal Medicine, Pain, The Lancet, and The New England Journal of Medicine.

Over the years, CMCC has developed relationships with faculty in other academic institutions in North America. Research collaborations have taken place with faculty from the University of Toronto, University of Waterloo, McMaster University, University of Western Ontario, Institute for Work and Health, St. Michael's Hospital, Sunnybrook and Women's College Health Sciences Centre, University of Calgary, University of Saskatchewan, The Texas Back Institute, and St. Joseph's Hospital, Hamilton. In 1996, CMCC partnered with the University of Waterloo to establish Canada's first chiropractic research clinic within a university.

As of May 2005, subsequent to a rigorous evaluation, CMCC was approved to grant degrees. Previously, graduates earned a Doctor of Chiropractic Diploma (D.C.) after a four year post-grad program. The new class of students admitted in Aug. will be presented with a Doctor of Chiropractic Degree at graduation. CMCC has become the first private educational institution in Ontario entitled to offer a professional, health-care degree, which is a reflection of both the thoroughness of the CMCC application and the quality of its infrastructure, administration, faculty and programming.

The degree to be conferred formally establishes the institution's placement within the academic hierarchy, putting it's program in a position comparable to other primary-contact, health-care professions. It will be regarded as an undergraduate, first professional, second entry, applied degree. Though called a Doctor of Chiropractic Degree, it is not to be confused with a PhD doctoral program.

4. How Is Chiropractic Regulated & Standardized?

Chiropractic is regulated by provincial statute in all provinces. For example, in Ontario, chiropractic has been governed by statute since 1925. Currently, it is regulated by the Chiropractic Act (1991) which is administered by the College of Chiropractors of Ontario created in accordance with the Regulated Health Professions Act (RHPA)(1991).

Chiropractors along with medical doctors, dentists, psychologists, and optometrists have the legislated right and obligation to communicate a diagnosis and to use the title doctor. The College of Chiropractors of Ontario, like the colleges in each of the other provinces, is established by legislation in the same manner, and with the same structure and similar regulations, as the regulatory bodies for other health professions. It is responsible for protecting the public, standards of practice, disciplinary issues, quality assurance and maintenance of competency.

5. Is Chiropractic Treatment Safe?

Before beginning practice, a chiropractor is required to pass rigorous national Board Examinations. Then he or she must pass another set of examinations applying to the Licensing Board for the right to practice. Chiropractors complete many hours of post-graduate instruction for an annual license renewal. Throughout his or her career a chiropractor will attend seminars, scientific symposia and read professional journals to keep up with ongoing research. This professional development keeps the chiropractor well-equipped with the skills needed to provide patients with safe and effective chiropractic care.

Just as the medical profession in general must be completely certain that the care they provide is safe, so too must the chiropractic profession. Few medical treatments have been scrutinized in as much detail as chiropractic. The safety and effectiveness of chiropractic treatment has been studied very carefully.

Complications from chiropractic treatments are rare. Your chiropractor will discuss all potential side effects and any risks along with the benefits of the care you receive. If your chiropractor diagnoses a problem that would be better treated by another health care professional, he or she will make an appropriate referral.

This information was adapted from a document created by the profession as an educational tool for media and other health care professionals.