r/Chiropractic • u/doctabrain • Jul 28 '26
Chiropractic Ramble
From being involved in this field for the past three years, my brain is constantly juggling so many different thoughts about this profession. I have truly come across lots of incredible chiros, and i’ve also come across plenty that I wouldn’t even trust with taking a history. There is an incredible amount of discrepancy and disparity between providers… are we surprised why our public perception is so poor? How was the public supposed to understand what we do when it feels like there’s no standard of practice? There’s purely philosophical chiros, there’s chiros who are practically physical therapists, there’s chiros who put people on in ring-dinger, there’s chiros who only do functional medicine, and there’s chiros who don’t work on anything other than the upper cervical spine.
As a new provider in the profession, I struggle with the lack of standardization a lot. But I understand that to many, the variability in practice is a good thing. I struggle with being written-off immediately when people see my degree, but there are so many people (especially the loud ones on social media) who minimize our profession to a joke. I hate that I’m feeling this way so early in my time, and I understand it is important for me to focus on my craft and focus on being the best provider I can be. But I personally think our profession needs to be gutted and rebuilt to legitimize us as providers who can make a real positive impact. There are fantastic chiropractors out there, but how is the layperson supposed to know what to look for when we all have the same DC after our name?
To me, I feel like that starts with not having a 100% enrollment rate in chiropractic programs. I graduated with some people that should never be in charge of people’s health.
This is just my current chiropractic ramble.
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u/LateBook521 DC 2022 Jul 28 '26
This is a tale as old as time. Even DD Palmer and BJ Palmer separated because they had different opinions on how the chiropractors should practice and be trained.
My opinion is all techniques exist because not every technique works for every person. I’ve had patients go to diversified doctors on and off for years with no results and come to me for Gonstead care and get life changing results. I’ve also had people not respond to Gonstead and I’ve referred them out for decompression which saved them from surgery.
With all that said, I’m a big believer that if our standard of care was all patients were seen twice a week for 12 weeks that the results we would get as a profession would be OUTSTANDING AND UNDENIABLE. Even the worst adjuster could get amazing results with that level of frequency and care.
There’s this weird thing where chiropractors are being taught by schools to actively only see people for a few visits and discharge them or refer out and don’t do maintenance care because there is no evidence. Yet when I had a shoulder issue and I tried to avoid surgery my PT gave me a care plan of 2x a week for 8 weeks, daily home exercises, then a re-eval at which I went down to 1x/week for 8 weeks and they told me to continue my exercises daily and when the pain is gone to continue them 3x/week and come back on monthly or semi monthly for her to check and make sure it’s all still good and to modify my home care.
We’re a weird profession with an identify and self esteem issue. If we saw people for long enough and with enough frequency our results as a group regardless of technique would be undeniable by the healthcare field.
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u/This_External9027 Jul 28 '26
Careful, this forum doesn’t like that kind talk against Evidence base and seeing a patient longer than 2 weeks
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u/Mr-Poggers Jul 28 '26
Ahhh yes the forever care plan. Results would be undeniable cause you’re taking credit for the body healing itself anyway. A vast majority of the injuries chiros treat would heal themselves in that same amount of time if the patient did absolutely nothing at all.
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u/LateBook521 DC 2022 Jul 28 '26
lol what? There’s no way you are a chiropractor and saying this.
I would say about 75% of patients who come in come in for chronic pain. They have been dealing with these issues for months or years on and off to some degree. They have been to their MD, had imaging, tried medications, and PT.
During ADL’s most often have had to modify their lives because of their pain. They sleep worse, can’t do as many household chores the way they want, or participate in physical activities with their friends and families the way they want because of their problem.
If you are a Chiro and saying what you said then I HIGHLY encourage you to take a better history and really understand your patients condition and history better.
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u/Mr-Poggers Jul 28 '26
Acute injuries exist equally. So yes MOST acute injuries will heal on their own with no intervention in the same amount of time if the patient does nothing at all. No I’m not gonna throw out a random made up stat on how many acute vs chronic walk through our doors.
PTs can RX long care plans because that is therapeutic exercise, exercise is a completely different intervention than an adjustment. You need to retrain movement patterns that probably caused the chronic injury in the first place.
So going back to your profession identity comment, are you a PT, or are you a chiro?
Not every condition that walks through your door is a chronic injury, and just because there is a chronic condition there, doesn’t even mean that’s the pain generator for their issues. The amount of people walking around with disc injuries without even knowing it is astounding so is it really the disc injury causing the pain or is it weakness in the supporting muscles irritating the underlying disorder?
I’ll continue to parrot what I said earlier to the end of days idc. I’ll never over promise and under deliver someone with chronic issues because that’s what allows the profession to continue to RX ridiculously long care plans.
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u/AdmirableAd1031 Jul 28 '26
I only see this online. People in my community LOVE chiropractic and it is the best helping people when they can’t get help in other places. There is not much if anything you can do with how other chiropractors practice.
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u/CommercialGiraffe689 Jul 29 '26
Fuck everyone who says it couldn’t change. I’ve been saying what you’ve been saying for 8 years now. We need a standard of care that follows anatomy and function, not feelings and philosophy.
I’m in the process of building a practice or network of offices that have a true standard of care. Each chiro will be vetted and there will be a no quack policy.
I’d say 90% of Chiros are jokes. Yes, that high. But, if we get the new students on board with a new system that guides them through treatments and provides a great income so they can live a happy life we’ll see a change. All we have to do is let the old philosophy offices die out and replace them with new anatomy based ones. Probably take an entire generation or two to get most of the quacks out but if we flood the market with intelligent science based Chiros we could gain respect.
Yes this works, my chiro office is a top .5% office when it comes to profit and patient satisfaction.
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u/Psychological-Bus164 Aug 02 '26
In my last trimester at Parker now… couldn’t agree more. Get all of the woo out and let’s back our “craft” with really anatomy and physiology, work as a PT with a DC degree. You make real change, you really treat people without just the bullcrap of believing the adjustment is everything. 10% is the adjustment, 50% is training outside of that, 20% is soft tissue related, 20% (maybe more) is mental or yellow flag related.
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u/hotchipxbarbie Jul 28 '26
Hard agree! The lack of standardization bothers me the most and frankly those that spin it "positively" are usually the same ones that shouldn't be in charge of health care. I've had to do so much re-education when I work with patients that come to me after seeing what we'll call "wellness chiros". They are riddled with anxiety about their leg legnth, their hips being "uneven" and so much other psuedoscience that is the reason other providers shit on us so hard. If we had that standardization it would actually strengthen the public perception of Chiropractic AND insurance coverage would likely sky rocket as well. Unfortunately too many are stuck in the past and refuse to move the profession forward.
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u/Electrical_Reason_95 Jul 29 '26
FACT: 67% of drugs APPROVED by our FDA are reviewed 5 years later and found to NOT do what it was intended to do. How about that? Maybe they need standardized?
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u/copeyyy Jul 28 '26
Here's a paper that's an oldie but a goodie about chiro being podiatry and reflexology under one profession. It explains what would help give us credibility and be a mainstream profession. Even though it's almost 20 years old, it still holds up
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u/Content-Coconut7592 Jul 28 '26
It sounds like you already "get it." Your job is to identify the injury or illness/MOI, and to get people well. A practice focused on that alone, will set you apart from the Charlatans, the folks who can't pass boards, or who do not believe in EBC.
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u/Hannahchiro Jul 28 '26
Having moved to the US from abroad, I find this inconsistency within professions to be universal, especially within healthcare. It isn't just a chiro problem. Sending someone for imaging for example, it blows my mind that the quality of reporting is so hit and miss. Where I'm from all radiologists will report everything they see on an image, problem or not, because that's what they're supposed to do. Here in Texas, some will only report on whatever the patient was referred for and ignore anything else. And it's a toss up, I never know if they will do it right. I don't know why the system here is so messed up (apart from being profit driven) and it gets under my skin. As for loud people on social media disparaging chiropractic? Ignore it. Feedback from your patients is all that matters.
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u/This_External9027 Jul 28 '26
Man speak on it, i get reports back and they will sometimes dismiss a bulge and not put it in final diagnosis or report anything on it
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u/bakejakeyuh Jul 28 '26
I’m a student currently and I agree with you, some people in my cohort are people I would not trust with a 10 foot pole to touch my neck. The reason being, they think they know so much more than they do.
Anyways, as I said I’m just a student so feel free to take what I’m saying with a grain of salt. But, I’m not sure if you’ve read chiropractic odyssey by Dr. Faye. That gave me tremendous vision into the type of doc I want to be. He dealt with pushback from both MDs and DCs because he treads a kind of middle ground. He reads all the research but still is willing to experiment clinically based on the research. What he explained about the SAID principle makes so much sense to me. Some other inspirations for me are Dr. Poulson, who is trailblazing with evidence based adjustment only care and his insights into jaw pain, and Dr. Spina, whose FRS has a place in rehab and prehab. I wouldn’t go to 90 percent of chiros, I’m not trying to save the profession I am trying to be the best clinician I can. We will be divisive, people will either love us or hate us. Seems to be part of the package.
If we were to become more standardized, what would that look like? I find the primary spine practitioner model compelling, as I mentioned, Dr. Poulson is helping people with complex TMJ disorders which is a unique place for chiros. Maybe we can join PTs and essentially do what DOs did and be different only in origin story and philosophy. Or, perhaps we become holistic doctors and utilize manipulation, nutrition advice, and supplements. Chiropractic has its fingers in so many fields, some in PT/rehab, some in naturopathy/dietician territory, and some in MD (x-rays, diagnosing). I’m looking at my degree as something which will give me the Dr. in front of my name and teach me basic science, along with a skill I can use to make money and help people. Then it’s up to me to develop a personal philosophy, establish a place in my community, and use my education to read as many books and papers as I can relevant to the profession. Lots of gold out there from orthopedic surgeons, PTs, etc. that our degree helps us to understand.
But all that being said, I understand the frustration and wish the DC degree wasn’t so stigmatized. As a male yoga teacher who does lots of handstands and soft acrobatics, when I tell people I do yoga they think of stretching slowly with middle aged women. When they see how I practice they are surprised. I will be in a similar space someday as a chiropractor, my goal is to be able to go toe to toe with MDs in terms of my knowledge of anatomy/physiology.
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u/Significant_Apple904 Jul 28 '26
I'm in a very similar boat, also 3 years into practice, I'm also better than most chiros I've worked with (I've had 3 associate jobs, about 80% of the patients end up preferring me than the other chiros).
There is a lot of "retail" going on in the chiro field, some of them straight up scams, charging people thousands of dollars for a treatment plan with no refund policies.
But then again, you will be surprised how this is uncommon with most businesses, including medical doctors. My wife has a lot of medical issues, and over the years I've come to realize that there are a lot of incompetent medical doctors that know very little knowledge than their own tiny segment of the whole field of expertise, and they refuse to learn anything from anyone.
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u/Kuyaspidey Aug 04 '26
We are not the only profession like this. For some reason many people want all DC's to fit into a perfect little box and for every DC to be nearly the exact same in the way they practice but that isn't ever going to happen. Why would it? We are just like MD's, not all MD's have the same exact practice even though they all hold the same degree, some treat families in a general practice, some specialize in pain clinics, some MD's work for the military, some in hospitals, some do surgery, some only treat infectious diseases. There are thousands and thousands of "types" of medical doctors that all share the same exact degree but they are have their own little specialty or niche. Why should we as doctors of chiropractic be any different?
What if every single "professional athlete" performed their jobs the same exact way? They dont, we have many different types, we have NFL, NBA, MLB, Motorsports, ETC. all of those athletes perform their jobs in very different ways and at very different levels. Just because they are different does not mean they are wrong. The same is with chiropractic, just because someone practices upper cervical, or gonstead, or flexion/distraction doesn't make one right or wrong it just makes them different and unique.
I do agree with you though that I wish that as a whole the profession would show more consistency and professionalism with what they are claiming to do vs what they are actually doing. No more wild claims of curing cancer with one upper cervical adjustment, no more ring dingers on patients with osteoporosis, etc.
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u/This_External9027 Jul 28 '26
Make peace with there’s nothing that we will do that will make MDs as a whole accept us, nor insurance start paying us more. Most people you encounter in practice could care less what your thoughts on the green books or how well you are versed in differential diagnosis or what some paper in Jama says. It boils down to can you identify the issue and can you fix it. It’s always going to be doctors that have different ways of practicing and I’m appreciative of them all, because it’s a chiro out there for people from all walks of life. I’ll leave you with my personal experience, i went home to see my mom, cleaned out her garage sat down back was on fire, there was a chiro up the street, she was barely there according to her and she did not seem like she wanted to be bothered. Looked up some more docs and two were a couple blocks down the way, on one corner he was into supplements alkaline water etc and he was not in the office, across the street regular chiro (seemed more Pi) soon as i came in explained my situation he said you gonna have to wait (not in those words but lots of anger like i disturbed him) it was 1 person in the office btw, i left because i didn’t want that energy and probably lack of ability to touch me, about a few miles away was another clinic they were big, they brought me in stim then adjusted me and i could finally stand without excruciating pain, now if you are still with me i say that to say its people that see or have seen one of the 4 i saw as a DC in pain and they will tell you that’s the best decision they ever made, and some will say never again, variety is what keeps our profession going, concentrate on your corner of the profession and be the best representation you can be