Well, I have managed to get most of the items you wanted. I have
repeated your statement just below to the heading of each point, so
that you would know what it is about.
CHIROPRACTIC AN OVER VIEW
In the United States, the Council on Chiropractic Education (CCE) is
in charge of setting minimum guidelines for chiropractic colleges;
however, additional requirements may be needed for a license depending
on the jurisdiction where a chiropractor chooses to practice.
Chiropractors often enter chiropractic school with a Bachelor's
degree, or with three years of post-secondary education in the
sciences and other appropriate coursework. The admissions requirements
for chiropractic colleges in the United States, while not as stringent
as schools for other health care professions in terms of the minimum
number of undergraduate semester hours (toward a bachelor's degree)
that are required on entrance, the actual percentage of applicants
with a four year bachelor's degree on entrance, the minimum GPA
required on entrance, and the actual average GPA of applicants on
entrance, require a four-year undergraduate degree in many such
colleges, although the minimum prerequisite for enrollment in a
chiropractic college set forth by the CCE is 90 semester hours. The
minimum cumulative grade point average for a student entering a
chiropractic college is 2.50. Commonly required classes include
communication or language skills, psychology, social science or
humanities, biology, organic and inorganic chemistry and physics as
well as the common medical classes in anatomy or embryology,
physiology, micorbiology, diagnsis neurology, x-ray, orthopedics,
obsetrics, obstetrics and gynecology, the process of credentialing
varies widely by country. The curriculum in a chiropractic school is
quite rigorous, resembling medical school at the basic course level;
however, the timeframe to attain a degree itself in a chiropractic
school is much less than that of a medical school. Coursework in
Chiropractic school may include study in gross anatomy, biochemistry,
embryology, micobiology, anatomy and physiology in the first half of
formal schooling. The last half of formal education focusses on
clinical patient care through clinical rounds in various settings.
Graduates of chiropractic schools have to complete five years of
schooling and pass four national board exams in order to complete
their education.
Graduates of chiropractic schools must sit for State examination to
qualify for licensure. Once licensed, most States require
chiropractors to annually attend 12 to 48 hours of continuing
education courses.
Well this well written piece at Wiki ?. I got hooked on this so much
that I spent good time reading everything there is.
CHIROPRACTORS
Total number of Chiropractors and numbers by state/metro area,
% of Chiro centers that are stand-alone, vs part of a group (ie "of
the 5,000 Chiropractic facilities, 80% are privately owned/operated,
10 % are part of a regional chain, and 10% are associated with
hospitals");
A comprehensive listing of registered Chiropractors could not be
located. Most of the sites are making this data only on payment. A
listing of 65000 Chiropractors is available as a directory.
Information on the directory:
The National Directory of Chiropractic
The National Directory of Chiropractic "printed version" has been the
chiropractic profession's directory for over 14 years. It is designed
mainly for use within the chiropractic community. The Directory is
made up of three parts and each serves a vital need for the
chiropractic clinic.
The White Pages, made up of over 65,000 listings, serve as the
profession's main referral tool. Listing the individual clinics'
services and techniques, it enables doctors to make educated decisions
when a referral is necessary.
The Yellow Pages include listings for the business aspect of
chiropractic including organizations, associations and colleges.
The Blue Pages is compiled of all the states' chiropractic
information. This section is designed to answer any questions a clinic
would have about a particular state.
The National Directory of Chiropractic was founded by a chiropractor
as a way to help serve his profession. It has evolved into a
foundation which is very proud to be maintaining and making available
the most accurate information on chiropractic.
ChiroDirectory
406 East 300 South, Box 305
Salt Lake City, UT 84111
1-800-888-7914
Fax: 877-568-4694
Email: Directory@Chirodirectory.com
http://www.chirodirectory.com/ob-Printed.html
PATIENT PROFILE\PERCENTAGE GOING FOR
COMPLIMENTARY AND ALTERNATIVE MEDICINE.
(Also would like info patient population. How many people see a
Chiropractor annually (by state if possible), )
From the site of National Centre for Complementary and Alternative
Medicine - it is an important write up having baring on the subject,
hence have copied it for your ready reference:
More Than One-Third of U.S. Adults Use Complementary and Alternative
Medicine, According to New Government Survey
According to a new nationwide government survey,1 36 percent of U.S.
adults aged 18 years and over use some form of complementary and
alternative medicine (CAM). CAM is defined as a group of diverse
medical and health care systems, practices, and products that are not
presently considered to be part of conventional medicine. When prayer
specifically for health reasons is included in the definition of CAM,
the number of U.S. adults using some form of CAM in the past year
rises to 62 percent.
"These new findings confirm the extent to which Americans have turned
to CAM approaches with the hope that they would help treat and prevent
disease and enhance quality of life," said Stephen E. Straus, M.D.,
Director, National Center for Complementary and Alternative Medicine
(NCCAM). "The data not only assists us in understanding who is using
CAM, what is being used, and why, but also in studying relationships
between CAM use and other health characteristics, such as chronic
health conditions, insurance coverage, and health behaviors."
The survey, administered to over 31,000 representative U.S. adults,
was conducted as part of the Centers for Disease Control and
Prevention's (CDC) 2002 National Health Interview Survey (NHIS).
Developed by NCCAM and the CDC's National Center for Health Statistics
(NCHS), the survey included questions on 27 types of CAM therapies
commonly used in the United States. These included 10 types of
provider-based therapies, such as acupuncture and chiropractic, and 17
other therapies that do not require a provider, such as natural
products (herbs or botanical products), special diets, and megavitamin
therapy.
Although there have been many surveys of CAM use to date, the various
surveys included fewer choices of CAM therapies. In addition, they
often surveyed smaller population samples primarily relying on
telephone or mail surveys versus in-person interviews used for this
survey. Thus, the results from the CAM portion of the NHIS provide the
most comprehensive and reliable data to date describing CAM use by the
U.S. adult population.
Overall, the survey revealed that CAM use was greater among a variety
of population groups, including women; people with higher education;
those who had been hospitalized within the past year; and former
smokers, compared to current smokers or those who had never smoked. In
addition, this was the first survey to yield substantial information
on CAM use by minorities. For example, it found that African American
adults were more likely than white or Asian adults to use CAM when
megavitamin therapy and prayer were included in the definition of CAM.
"We're continuously expanding the health information we collect in
this country, including information on the actions people take in
dealing with their own health situations," said NCHS Director Edward
J. Sondik, Ph.D. "Over the years we've concentrated on traditional
medical treatment, but this new collection of CAM data taps into
another dimension entirely. What we see is that a sizable percentage
of the public puts their personal health into their own hands."
CAM approaches were most often used to treat back pain or problems,
colds, neck pain or problems, joint pain or stiffness, and anxiety or
depression. However, only about 12 percent of adults sought care from
a licensed CAM practitioner, suggesting that most people who use CAM
do so without consulting a practitioner. According to the survey, the
10 most commonly used CAM therapies and the approximate percent of
U.S. adults using each therapy were:
? Prayer for own health, 43 percent
? Prayer by others for the respondent's health, 24 percent
? Natural products (such as herbs, other botanicals, and enzymes), 19 percent
? Deep breathing exercises, 12 percent
? Participation in prayer group for own health, 10 percent
? Meditation, 8 percent
? Chiropractic care, 8 percent
? Yoga, 5 percent
? Massage, 5 percent
? Diet-based therapies (such as Atkins, Pritikin, Ornish, and Zone
diets), 4 percent.
In addition to gathering data on the use of CAM practices, the survey
also sought information about why people use CAM. Key findings
indicate that:
? 55 percent of adults said they were most likely to use CAM because
they believed that it would help them when combined with conventional
medical treatments;
? 50 percent thought CAM would be interesting to try;
? 26 percent used CAM because a conventional medical professional
suggested they try it; and
? 13 percent used CAM because they felt that conventional medicine was
too expensive.
Interestingly, the survey also found that about 28 percent of adults
used CAM because they believed conventional medical treatments would
not help them with their health problem; this is in contrast to
previous findings that CAM users are not, in general, dissatisfied
with conventional medicine.
The results of the survey reveal new patterns of CAM use among various
population groups and provide a rich source of data for future
research. Furthermore, the survey results provide a baseline for
future surveys, as it establishes a consistent definition of CAM that
can be used to track trends and prevalence of CAM use.
1 Barnes P, Powell-Griner E, McFann K, Nahin R. CDC Advance Data
Report #343. Complementary and Alternative Medicine Use Among Adults:
United States, 2002. May 27, 2004.
The link:
http://nccam.nih.gov/news/2004/052704.htm
NATIONAL CENTRE FOR HEALTH STATISTICS
Description of Chiropractic market segment (actually pretty much have
that covered from above links),
general info on their treatments (ie, "30% of all visitors (patients)
had back related issues, while 20% and 30 % had knee and hip pain
respectively" (that's a made up example), but I'm guessing the
breakdown of why people visit a Chiro is known and published
somewhere.
A detailed survey on chiropractic ? giving various details
http://nccam.nih.gov/news/report.pdf
Page 8 to 13 gives tabulated data:
Some details based on the data on these tables are discussed in page
nos given in the bracket:
Table one (Page 3) Use of CAM
The 10 CAM therapies most commonly used within the past 12 months
measured in terms of the percentage of US adults were : Chiropractic
care 7.5%, yoga 5.1%, massage 5.0%, and diebased therapies 3.5%,
prayer(own) 43.0%, prayer for others 24.4% natural products 18.9%,
deep breathing exercies 11.6%, prayer group participation (own) 9.6%
Table three (page-4) Medical conditions treated with CAM
CAM was most often used to treat back pain, or problems head or chest,
colds neck pain, or problems, joint pain or stiffness, and anxiety or
depression.
Table four (page 4) Use of CAM by selected characterists
-Women were more likely than men to use CAM
- White adulsts 12.0% were more likely to use manipulative and
body-based therapies than Asian adults 7.2% or black adults 4.4%
- Use of CAM increased as education level increased
- For adults under 65 years of age, those with public health insurance
were more likely than adults with private health insurance to use CAM
Table five (page 5) Selected reasons for using CAM
- Adult CAM users were most likely to utilise CAM because they
believed that CAM combined with conventional medical treatments would
help 54.9%
- About one half of adult CAM users initially utilized CAM because
they thought it would be interesting to try 59.1%
- 26% of adult CAM users utilized it because a conventional medical
professional suggested they try it.
- 28% percent of adult CAM users believed conventional medical
treatments would not help them.
- 13% of adult CAM users used CAM because they felt that conventional
medicine was too expensive.
YOU HAVE TO CHECK THE PAGE 8-13 OF THIS PDF
Though the data is not statewise, data in page 8 to 13 are what you
are looking for :
Advance data 27.5.2004 Extract ?
Ever used
Used in last 12 months
Chiropractic care 40242 19.9% 15,226 7.5%
Massage 18899 9.30% 10,052 5.06%
The data of these pages are too big to be accommodate here. Hence
please link to the pdf for better understanding of the data.
http://nccam.nih.gov/news/report.pdf
REIMBURSEMENT
(Would also like general info on reimbursement (overview of how it
works and an overview of how much is covered).
Compared with CAM therapies as a whole (few of which are reimbursed),
coverage of chiropractic by insurance plans is extensive. As of 2002,
more than 50 percent of health maintenance organizations (HMOs), more
than 75 percent of private health care plans, and all state workers'
compensation systems covered chiropractic treatment.1 Chiropractors
can bill Medicare, and over two dozen states cover chiropractic
treatment under Medicaid.
If you have health insurance, check whether chiropractic care is
covered before you seek treatment. Your plan may require care to be
approved in advance, limit the number of visits covered, and/or
require that you use chiropractors within its network (read more in
the NCCAM fact sheet.
Please read this --
http://www.bls.gov/opub/mlr/2004/01/art2exc.htm
?..Also, in California, chiropractic and physical therapy treatments
were limited to 24 visits for the life of the claim, while Florida
increased chiropractic treatment from 18 visits to 24 visits, and the
number of weeks of treatments from 8 to 12.
2) Insurance:
Really there is a lot one should look into:
Coverage Clarification
http://www.acatoday.org/insurance/managed_care/coverage_clarification.cfm
Coverage and limitations ? Chiropractic services
From Carriers Manual Part 3 Chapter II Coverage and Limitations
Chiropractic Services
2250. CHIROPRACTIC SERVICES - GENERAL
Here the scope of Chiropractors is lined out in detail from the
insurers point of view.
2250. CHIROPRACTIC SERVICES - GENERAL
The term "physician" under Part B includes a chiropractor who meets
the specified qualifying requirements set forth in §2020.26 but only
for treatment by means of manual manipulation of the spine to correct
a subluxation.
Effective for claims with dates of service on or after January 1,
2000, an x-ray is not required to demonstrate the subluxation.
----- I copies the entire text here, and removed part of it later on
as the overall size of the documents gets increased to 20 pages.
Hence please link for further information on this, which I consider is
very important for Chiropractor as it gives full details of
documentation etc. to be submitted with a claim. (now from 20 I
reached 13 pages)
Link
http://www.cms.hhs.gov/manuals/14_car/3b2250.asp
DETAILS PROBLEMS (you did not ask for it, though)
The following information is taken from Vertebrobasilar Stroke, by
Allan G.J. Terrett
Incidence of VBS following Spinal Manipulative Therapy (SMT):
1972 ? Maigne suggested: ?There is probably less than one death of
this nature out of several tens of millions of manipulations.?
1978 - Cyriax stated: ??this risk works out to about one in ten
million manipulations, and is no argument against manipulative
reduction in suitable cases.?
1981 ? Hosek et al suggested: ??we may form a conservative likelihood
estimator by looking at the ration of vertebrobasilar injuries to
adjustments performed. This ration would be 100 injuries per 100
million adjustments?one in about one million.?
1983 ? Gutman concluded: ?There are 2-3 serious incidents involving
the vertebrobasilar system occurring in 1 million manipulations to the
upper cervical spine.?
1993 ? Carey found: ?In a study of a five year period (1986-1990),
using statistics from Provincial Governments of Canada, the Canadian
Protective Association, and reported legal/insurance claims, concluded
an incidence rate of one in every 3,846,153 neck manipulations. None
involved death, one had complete recovery, six had some neurologic
deficit, four completely resolved, and two had psychological problems,
but no physical deficit. If the Province of Quebec were isolated, with
14 million manipulations performed and only one CVA in a five year
period, there would be an incidence of one in 14 million.?
1995 ? Dabbs and Lauretti following their research wrote ??in a three
year period 1991 to 1993, NCMIC closed a total of 96 claims for
cerebrovascular accident. Of this total, 61 were closed with payment
and 35 were closed without payment. If one concludes that there was
little or no merit to the 35 claims that were closed without payment,
this would average 20 cerebrovascular accident claims per year. This
figure was recently accepted by a popular consumer magazine as a
correction to a previously published article (Corrections. Consumer
Reports March 1995, page 132). Because NCMIC insures about one-half of
the US chiropractic profession, their members should be similar to the
national average?Curtis and Bovee report that rotary adjustments of
the cervical spine make up about 30% of the visits made to
chiropractors. Therefore, chiropractors insured by NCMIC each
performed some 1,800 cervical manipulations in each of the three years
reported above. Considering these numbers, we calculate that NCMIC?s
24,000 D.C.?s perform some 43 million cervical manipulations per year.
Twenty post SMT strokes indicate a rate of less than one stroke per 2
million cervical manipulations.?
Link:
http://www.chiropracticissafe.org/
PROCEDURE AND TIME FOR TREATMENT
(how long an average patient is treated (ie "five visits over two
weeks averaging about 15 minutes per visit")
From a site:
If you become a chiropractic patient, during your initial visit the
chiropractor will take your health history. He will perform a physical
examination, with special emphasis on the spine, and possibly other
examinations or tests such as x-rays.15 If he determines that you are
an appropriate candidate for chiropractic therapy, he will develop a
treatment plan.
When the chiropractor treats you, he may perform one or more
adjustments. An adjustment (also called a manipulation treatment) is a
manual therapy, or therapy delivered by the hands. Given mainly to the
spine, chiropractic adjustments involve applying a controlled, sudden
force to a joint. They are done to increase the range and quality of
motion in the area being treated. Other health care
professionals--including physical therapists, sports medicine doctors,
orthopedists, physical medicine specialists, doctors of osteopathic
medicine, doctors of naturopathic medicines, and massage
therapists--perform various types of manipulation. In the United
States, chiropractors perform over 90 percent of manipulative
treatments.16
Most chiropractors use other treatments in addition to adjustment,
such as mobilisation massage, and nonmanual treatments (see examples
in the
Examples of Nonmanual Chiropractic Treatments1
1) Heat and ice
2) Ultrasound
3) Electrical stimulation
4) Rehabilitative exercise
5) Magnetic therapy
6) Counseling about diet, weight loss, and other lifestyle factors
7) Dietary supplements
8) Homeopathy
9) Acupuncture
First Visit
After filling out the necessary paperwork, the Dr. (she) will take a
thorough history of patients current problem, any previous health
concerns, and ask about current exercise and diet of the patient. The
Dr will then do a thorough examination, during which she?ll let you
know if she finds anything significant. Afterward she will discuss
treatment options with the patient. The initial visit usually also
includes a small treatment.
Allow one and a half hours for this first visit.
Subsequent Visits
The Dr. will always take a short history, review any exercises that
the patient was given, re-examine the area of concern, and then treat
the condition appropriately.
TREATMENT
The Patient may be treated using both active and passive methods.
Active care includes rehabilitative exercises to normalize joint and
muscle function. Passive care includes various manual techniques as
well as modalities such as ultrasound and interferential current. It
is found that the therapies that will work best to help the patient?s
body to heal quickly and to improve function for the future.
PASSIVE THERAPY
Chiropractic Adjustive Techniques:
Diversified adjustments, biomechanical blocking, biomechanical use of
Activator®, Cox flexion/distraction, oscillatory and reflex
techniques.
Physical Modalities:
Various massage and soft tissue techniques, ultrasound, interferential
current, TENS, taping.
ACTIVE THERAPY
An active therapy program is customized for each individual patient.
The therapy may consist of:
Stretching
Strengthening
Proprioception/coordination exercises
A low-tech approach is used with no or minimal equipment. (Swiss Ball,
rocker-board, foam roller, exercise bands or tubing)
Thanks to: Dr.Seaton for the above
http://www.drjessicaseaton.com/About%20the%20Office/Treatment.htm
EARNINGS OF CHIROPRACTORS (again, you did not ask for it)
Median annual earnings of salaried chiropractors were $65,330 in 2002.
The middle 50 percent earned between $44,140 and $102,400 a year.
Self-employed chiropractors usually earn more than salaried
chiropractors. According to the American Chiropractic Association, in
2000, the average income for all chiropractors, including the
self-employed, was about $81,500 after expenses. In chiropractic, as
in other types of independent practice, earnings are relatively low in
the beginning and increase as the practice grows. Geographic location
and the characteristics and qualifications of the practitioner also
may influence earnings. Self-employed chiropractors must provide for
their own health insurance and retirement.
November 2004 Occupational Employment and Wage Estimates
ftp://ftp.bls.gov/pub/special.requests/oes/oesn04nat.zip
OR SEE EXCEL CHIRO IN YOUR INBOX.
EQUIPMENTS/ACCESSORIES
(as well as what percent of Chiropractors use medical equipment
(beyond just doing spine manipulation.
Lastly (not expected.... but just in case you come across this info),
would welcome info on leading dealers/distributors of products into
this industry.}
The basic equipment/accessirues used by Chiropractors are (Swiss
Ball, rocker-board, foam roller, exercise bands or tubing)
Given below is a link to the price list of accessories like xray,
table, ball, bands, mats etc. from :
Ball Dynamics Ainternational, Longmont CO 80504.
http://www.balldynamics.com/BDIPriceList.pdf#search='Swiss%20Ball%2C%20rockerboard%2C%20foam%20roller%2C%20exercise%20bands%20or%20tubing'
http://www.nefitco.com/index.php
http://www.hessco.com/
http://www.ajmedxray.com/summitchiropractic.html
http://www.hilllabs.com/
THAT?S IT. |
