Paul G. Shekelle, M.D., Ph.D.

Chiropractic in the United States: Insurance Coverage
October 10, 2019 by , , ,

**Comments in red by Stephen Barrett, M.D. A. Sources of Reimbursement for Chiropractic Services Although many patients still pay out-of-pocket for chiropractic services, most now have insurance that pays part of the cost. The two best sources of information about payment for chiropractic services are the annual survey of the members of the American Chiropractic Association (who comprise roughly 25 percent of all the licensed chiropractors in the U.S.) and a recent study of chiropractic utilization in five geographic areas of the U.S. (Goertz, 1996; Hurwitz, in press). The ACA had 12,252 members (excluding students) as of November 1, 1996 (Goertz, 1996b). This represents roughly 25 percent of the 50,000 chiropractors believed to be licensed in the United States (Cooper, 1996).The 1995 ACA data describe the …

Chiropractic in the United States: Content of Practice
October 10, 2019 by ,

**Comments in red by Stephen Barrett, M.D. A. Presenting Problems and Diagnoses Two studies of national scope have tried to describe what chiropractors actually do in practice. The first was a national survey of over 5,000 practicing chiropractors (Christensen, 1993), which asked what conditions patients presented with or had concurrently. The second, using data collected from the office records of a cluster sample of chiropractors, looked at the presenting symptoms the chiropractors recorded in charts and at diagnoses recorded for insurance purposes (Hurwitz, 1998). Both studies collected data in the early 1990s. These studies allow for a comparison between what chiropractors indicate they do in response to a survey and what they actually record for specific patients in their office records. The patient conditions that chiropractors …

Chiropractic in the United States: Supply and Utilization
October 10, 2019 by ,

**Comments in red by Stephen Barrett, M.D. A. Current and Projected Supply of Chiropractors In 1970, there were an estimated 13,000 chiropractors licensed in the United States (Cooper, 1996). This number had increased to 40,000 in 1990 and to approximately 50,000 in 1994. Thus, there is roughly one chiropractor for every 5,000 U.S. residents. Estimates of the proportion of chiropractors who are in full-time practice range from 82 percent in a large national survey conducted in 1993 (Christensen) to 96 percent in a 1995 survey of members of the American Chiropractic Association (Goertz, 1996). Almost 90 percent of chiropractors report working at least 30 hours per week (Christensen, 1993), and the average chiropractor claims to work about 42 hours per week (Goertz, 1996). Estimates of …