Running head: SYLLABUS, LECTURE NOTES, HANDOUTS

Three-Week Class on Chiropractic Therapy

Heather Sachariason
Kaplan University

SYLLABUS, LECTURE NOTES, HANDOUTS

Three-Week Class on Chiropractic Therapy

Syllabus
This three-day course provides high school students who are considering attending
medical school with an in-depth description about chiropractic therapy. During these three 90minute classes we will discuss the following:
Day 1

What is chiropractic therapy?

History of chiropractic therapy

Day 2

Reasons people seek out chiropractic care

Procedures and tools of the trade

Day 3

Research, education, licensing and certifications

How/where to find a reputable chiropractor

Insurance coverage for chiropractic procedures

After completing this three-day course, each high school student will have a better
understanding of chiropractic medicine and if it is something they wish to pursue personally and
professionally.

SYLLABUS, LECTURE NOTES, HANDOUTS

Day 1 Lecture Notes

What is chiropractic therapy?

Explain what complementary and alternative medicine is using the NIH definition:
Complementary and alternative medicine (CAM) is the term for medical products
and practices that are not part of standard care.
o Standard care is what medical doctors, doctors of osteopathy, and allied
health professionals, such as nurses and physical therapists, practice.
o Complementary medicine is used together with standard medical care. An
example is using acupuncture to help with side effects of cancer treatment.
o Alternative medicine is used in place of standard medical care. An example
is treating heart disease with chelation therapy (which seeks to remove excess
metals from the blood) instead of using a standard approach. (NIH, 2014)

Further explain that chiropractic medicine and therapy falls within the CAM
practices. The word chiropractic comes from the Greek words cheir (hand) and
praxis (action) meaning done by hand.

Doctors of Chiropractic (DC) provide patients with a non-invasive and safe system of
care.
o Most conditions cared for by chiropractors are acute or chronic conditions of
the spine and extremities
o DCs utilize both allopathic - ask if anyone in the audience can define
allopathic. Make sure everyone understands
o DCs focus on a system of care which is complementary to the allopathic
system of care
o Chiropractic is also alternative with a philosophy that neurophysiological
balance as the key to enhanced health

SYLLABUS, LECTURE NOTES, HANDOUTS

o Its really the best of both worlds (allopathic and alternative)

Chiropractic is the third largest health profession in the western world (following
allopathic and dentistry)

But this was not always the case! Not too long ago chiropractors were arrested for
practicing medicine without a license.

History of chiropractic therapy

Go over the general state of healthcare in the late 1800s it was exploratory and new;
some felt hospitals were where the sick went to die.

Now explain the colorful history of DD Palmer and his son BJ Palmer
o Daniel David (D.D.) Palmer founded chiropractic in 1895 in Davenport, Iowa.
Go over his background (fish merchant but interested in magnetic healing and
other new ideas.
o DD did not invent spinal manipulation as a tool to cure disease (that dates back to
Hippocrates) but he claimed to be the first to use specific contacts as shortleverage points for making more specific spinal adjustments (Kuusisto, 2006)
o First patient was a deaf man named Harvey Lillard who regained his hearing for
the first time in two decades. Everyone thought DD had a cure for deafness which was not the case.
o DD Palmer founded the Palmer School of Chiropractic, which is now one of the
leading colleges for chiropractic.
o DDs son, BJ (who was part of a travelling Vaudeville show working as a
hypnotic subject) joined in developing the school.

SYLLABUS, LECTURE NOTES, HANDOUTS

o Shortly thereafter DD was arrested and imprisoned for practicing medicine

without a license.

Make sure to mention that chiropractors were routinely arrested for the same reason
during the 1950s. Rather than use the words diagnosis and treatment they used assess
and adjust in their place.

Finally in 1974, chiropractic licenses could be obtained in all states.

The American Medical Association (AMA) waged a war against chiropractic treatment.
o Go into the whole story about how the AMA conspired to contain and eliminate
the chiropractic profession
o How the large packet of confidential AMA documents were left anonymously on
the doorstep of the International Chiropractors Associations headquarters
o How the AMA was ordered by the US Supreme Court to pay an undisclosed sum
most of which was earmarked for chiropractic research.

Questions and Answers

Review what Day Two will look like
Provide handout and say good-bye

SYLLABUS, LECTURE NOTES, HANDOUTS

Day 1 Handout
What is Chiropractic? As stated earlier, chiropractic is a system of healthcare that is
based on sustaining neurophysiological balance within the body. This system respects
homeostasis, which is the body's innate drive to self-regulate. Chiropractic also
emphasizes the relationship between structure and function, and holds that the nervous
system is the primary coordinator of function throughout the body.
In correcting structural stresses or biomechanical irritation to the nervous system,
chiropractic focuses on the integrity of the spine and its surrounding tissues. A person's
state of health is found along a continuum, and "dis-ease" is not necessarily the effect of
interest. Disease instead may be seen as a cause of interference on that continuum
restricting optimal health.
We set our sights on the highest attainable level of health, rather than viewing the
disease itself as the target of interest. Health is not the absence of disease, but
diseases can be obstacles in the way.
A Complete System of Healthcare: Chiropractic is a complete system of healthcare,
much like Osteopathy and Allopathic Medicine. It is not simply a modality of treatment.
Its philosophical orientation is in the preservation and restoration of health rather than in
the cure of disease. Its approach is non-invasive and chiropractors do not prescribe
pharmaceuticals.
The word "chiropractic" combines the Greek words cheir (hand) and praxis (action), and
simply means, "done by hand." Due to its rather awkward name and its focused
attention on the spine, the profession is often thought of by its tools and by its avenue of
care. Chiropractic, however, is not just about manual care of the spine, although it has
also built a reputation caring for that often-troublesome piece of anatomy.
Chiropractic is Both Complementary and Alternative: Many of the conditions
typically cared for by chiropractic are acute or chronic conditions of the spine and
extremities. Manual treatment of these conditions assumes an allopathic approach and
much of chiropractic education and research has focused on this important aspect of
care. In this way, chiropractic is a system of care, which is complementary to the
allopathic system of care.
On the other hand, the roots of chiropractic are distinctly alternative. It is based on an
alternative philosophy of innate intelligence and a goal of neurophysiological balance as
the key to enhanced health. Complementary and alternative approaches are not
mutually exclusive concepts and, in practice, many first-time patients will be encouraged
to understand that overcoming their back pain or headache is a first step, and that
ongoing preventive care is a better way to sustain their health and quality of life.
Handout provided by: The University of Minnesota, Center for Spirituality and Healing

SYLLABUS, LECTURE NOTES, HANDOUTS

Day 2 Lecture Notes
Types of chiropractic therapy

Discuss the reasons people seek out chiropractors

o Most common are low back issue, head aches, muscle aches, whiplash, and
extremity issues
o Also used to treat patients with hypertension, scoliosis, MS, ADHA, HBP, GI
issues, colic, fibromyalgia and vision (explain what these diseases/disorders are0
o Show the video of an adjustment with the woman who has MS now
http://www.csh.umn.edu/Integrativehealingpractices/chiro/app/videos/mshs.html

Discuss what a chiropractic session is like

o First step involves an exam, x-rays then home.

During the first consultation, patients are asked about information

regarding pain (e.g. location and severity) and about general health
conditions (e.g. healthy? heart condition? cancer?)

During the exam, if there are any indications of major organ issues or
other areas of concern, patient is typically referred to a medical specialist.

o Second consultation typically consists of a report of findings, explanation,

adjustment followed by 20 minutes of rest, then a reexamination.
o After that, regular adjustments are scheduled for preventative care (this is typical
of CAM providers)

Provide an overview of the spine (vertebrae, discs, spinal cord) and nerves.
o Explain to the class that certain chiropractic treatments are designed for specific
areas of the spine.

SYLLABUS, LECTURE NOTES, HANDOUTS

Discuss in detail the types of chiropractic treatments

o Spinal Manipulation the most common treatment

Show 5 minute YouTube video

https://www.youtube.com/watch?v=pv4ep8rOAcc

o Activator Technique (called Blair) utilizes a tool (show picture of the tool)

Show 7 minute YouTube video

https://www.youtube.com/watch?v=QpsP9mnRdls

o Thompson Technique utilizes a table (show picture of the table)

Show 5 minute YouTube video

https://www.youtube.com/watch?v=grqzFdoV93Q

o Manipulation under anesthesia (done in conjunction with an anesthesiologist)

Show 10 minute YouTube video

https://www.youtube.com/watch?v=i7kpcvlI4Yc

Questions and Answers

Review what Day Three will look like
Provide Handout and say goodbye

SYLLABUS, LECTURE NOTES, HANDOUTS

Day 2 Handout

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Day 3 Lecture Notes

Research, Education, licensing and certifications

Tell the students a story of my friend who is a chiropractor and how her first year of
college went.
o Tell the story of how she decided to go to chiropractic college (after she was not
accepted to veterinary college)
o How she truly didnt understand what chiropractic was initially getting past the
feeling that it was almost cultism
o Fighting the Fight for chiropractic (the fight being the lack of research and
resources allocated for research.)

Since chiropractors do not prescribe medication, they dont receive large

amounts of research funding from pharmaceutical companies.

Federal support for chiropractic research began in 1992 with the

establishment of the National Center for Complementary and Alternative
Medicine (NCCAM) of the National Institutes of Health.

Prior to NCCAM, most colleges self funded their research programs.

Discuss the requirements for getting accepted to a chiropractic college, the length of the
program and the licensing and certification required to practice (found on the University
of Minnesota, Center for Spirituality and Healing):
o Admission to chiropractic programs requires pre-professional education with a
minimum of 90 semester credits with an emphasis in the biological sciences, and
distributed hours in humanities and other areas.
o Accredited chiropractic programs require a minimum of 4,200 class hours, most

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often accomplished in ten trimesters.

o Chiropractic students planning to be licensed in North America must also pass a
four-part national board examination before receiving their degree.
o Doctors of Chiropractic are licensed separately by each state. Chiropractic
regulatory boards are in most cases separate from medical regulatory boards.
o All but two states in the US require annual continuing education requirements as a
basis for re-licensure; most in the range of 20-25 hours per year. Some specified
requirements are common, most often in the areas of radiography, professional
boundaries, and clinical skills development.
How/where to find a reputable chiropractor

Explain that referrals from friends and family are great ways to find a good chiropractor.
Another good source is your current healthcare provider; they can give you an opinion on
whether or not that particular doctor-patient relationship might be a good fit for you.

Remind them that communication is a key element, as well as the goals of care, the
methods used, and the particular interest or specialization of the doctor. It is important to
find a good fit (UM, 2014).

State trade associations can also be used. Chiropractic specialty board certification is
important when seeking specialized care.

Most managed care plans include a chiropractic benefit, but the provider networks are often
limited, so be sure to check with your insurer up front.
This leads to reimbursement for Chiropractic Procedures:

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Insurance coverage for chiropractic procedures

Discuss how times are changing and how more insurance companies are covering
Chiropractic procedures.

In 1972, the federal government included reimbursement for chiropractic care under
Medicare. Following that action, private insurers followed and most insurers and
managed care organizations now cover chiropractic care, with limitations. Third party
payers authorize payment under the same CPT coding system as medical providers (UM,
2014).

A profession-specific set of codes, Chiropractic Manipulative Terminology (CMT)

parallel the codes used by Doctors of Osteopathy and describe service encounters by the
intensity of the examination and the number of spinal or extremity areas treated.
Components of a Resource Based Relative Value Scale are similar between medicine and
chiropractic, but are not identical. Most preventive care is still paid for out of pocket
(UM, 2014).

Questions and Answers

Review we covered over the week
Discuss the Handout
Say goodbye and good luck!

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Day 3 Handout

Additional Information and Resources

The University of Minnesota, Center for Spirituality and Healing website is a wealth
of information. If you have particular interest in Chiropractic (or other CAM techniques)
please visit the Free Online Learning Modules at http://www.csh.umn.edu

The Council on Chiropractic Education (CCE) http://www.cce-usa.org is the national

accrediting Agency for Doctor of Chiropractic Programs within the United States. At
this site you will find information, publications, forms and a variety of resources.

The American Chiropractic Associations (ACA) website is another wealth of

information. At this site you will be able to find a doctor, learn more about
reimbursement and find answers to virtually any questions you have. This site is
designed for doctors, patients, students, insurance companies and sponsors.
http://www.acatoday.org/search/memsearch/

If you are interested in learning about chiropractic colleges, in addition to the ACA
website mentioned above, you can also visit the Association of Chiropractic Colleges
(ACC) http://www.chirocolleges.org

The National Center for Complementary and Alternative Medicine (NCCAM) is

another excellent and respected resource for information on Chiropractic and other CAM
practices http://nccam.nih.gov/health/chiropractic/introduction.htm

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Reference
Conrad Chiropractic. (2008). Standard Chiropractic Spinal Adjustment. Retrieved from
https://www.youtube.com/watch?v=pv4ep8rOAcc
Kuusisto, L., PhD, DC. (2006). The University of Minnesota, Center for Spirituality and
Healing. Chiropractic. Retrieved from
http://www.csh.umn.edu/Integrativehealingpractices/chiro/index.html
Life University. (2013). Thompson Club Technique: Leg Check Analysis. Retrieved from
https://www.youtube.com/watch?v=grqzFdoV93Q
National Institutes of Health. (2014). Medline Plus: Complementary and Alternative Medicine.
Retrieved from
https://www.youtube.com/watch?v=i7kpcvlI4Ychttp://www.nlm.nih.gov/medlineplus/co
mplementaryandalternativemedicine.html
Pro Health Center. (2010). Manipulation Under Anesthesia. Retrieved from
https://www.youtube.com/watch?v=i7kpcvlI4Yc
Tarpo, M. (2014). Dr. Marla Tarpo Activator Adjustment. Retrieved from
https://www.youtube.com/watch?v=QpsP9mnRdls
University of Minnesota. (2014). Center for Spirituality and Healing. Free Online Learning
Modules: Integrative Healing Practices. Chiropractic. Retrieved from
http://www.csh.umn.edu/free-online-learning-modules/index.htm