Chiropractic is an alternative form of healthcare that focuses on the musculoskeletal system. This system includes the bones, joints, tendons, and ligaments of the body. Chiropractors use their hands to examine, diagnose and treat problems with these systems. They also perform “adjustments” to improve how these systems work with each other. Unlike MDs and DOs, who focus on the heart, blood vessels and internal organs, chiropractors are trained to see subtle signs of neurologic problems such as headaches and dizziness. This is why many people go to a chiropractor for back pain and neck/back injuries. However, they may be referred by a physician for conditions such as high blood pressure, asthma, heartburn/GERD or bladder infections.
The survey results indicate that chiropractors perceive their role as primary contact practitioners. Central to this perception is the ability to arrive at a musculoskeletal diagnosis and refer patients when appropriate. Chiropractors see themselves working in a primary healthcare setting and this is in line with the Department of Health definition of an Allied Health Professional (AHP) [1].
Most respondents agreed that they are able to provide treatment for most common medical conditions if they were referred by a physician. They would like to have access to the same referral information that is available to physicians. This would facilitate better communication and collaboration.
It is worth noting that respondents from the UK differed from those from the US regarding their views on what is considered a primary care practitioner. The UK definition is based on role rather than setting and therefore it is less prescriptive than the US definition of a primary care provider.
The majority of respondents felt that the current scope of practice in the US is too restrictive. The US scope of practice excludes some activities that are part of the primary care model in other countries such as performing venipuncture for diagnostic purposes, ordering laboratory and diagnostic tests, including nerve conduction studies and ultrasound, signing birth or death certificates, dispensing nutritional supplements, and providing functional testing, eg, for thyroid function, blood sugar, hormone levels, food intolerances.
Some states allow chiropractors to do a limited number of the tasks that are included in the primary care model such as performing venipuncture for a blood test, and ordering diagnostic tests such as nerve conduction studies and ultrasound. In addition to the US, several European countries have similar scopes of practice that include these services in their primary care model. Having a uniform scope of practice for family chiropractor in Atlanta and other parts of the world could decrease confusion of the public, improve professional mobility, decrease reciprocity challenges, and facilitate the use of chiropractic services. Further research is required to explore the feasibility of introducing these functions into the scope of practice of chiropractors. This would require well-conducted trials on whether the quality of health care is jeopardized with a wider scope of practice. It is also important to determine whether the implementation of a broadened scope of practice will reduce health care costs.