Chiropractic Principles: Global Education and Governance

Chiropractic first arose as a separate profession in the United States in the 1890s. Over a century later, chiropractic educational institutions now exist in many countries around the world with practicing chiropractors in over 100 countries (1). A total of ninety of these countries are now associated with a national unity known as World Federation of Chiropractic (WFC) (1). The WFC has been a non-governmental organization that has been affiliated with with the World Health Organization (WHO) since 1997 (1). Worldwide information regarding the chiropractic profession is compiled and made available by the WFC and its members.

In the past, there were few governing bodies and health authorities present globally to recognize the chiropractic profession. Today there is now legislation to recognize and regulate the chiropractic profession in Africa, Asia, Pacific region, Eastern Mediterranean region, Europe, Latin America, and North America (2). Legislations do vary in some manner between individual counties but typically allows for direct patient contact without medical referral and define a concrete scope of practice (3). In all these geographical regions defined by WHO, legislation authorizes chiropractors as primary health care providers (3). In addition, the legislation gives chiropractors in these districts the ability and right to provide a diagnosis, as well as the right to order diagnostic imaging (2).

Although these regional classifications can relate in regards to legislation, there is a great deal of misunderstanding when discussing the extent and quality of chiropractic education. For instance, in North America there is a minimum requirement of 7 years of post-secondary education in order to qualify as being a chiropractor (2). In addition, all aspects of education must meet official accreditation standards determined by the province or state to which the individual wishes to practice (2). Lastly the graduate must also complete a national licensing board examination before earning the right to practice (2). Despite broad international standards of education, counties such as Australia, Brazil, Mexico, South Africa and the United Kingdom allow students to enter chiropractic education directly from high school (2). In addition, all of the countries previously listed are within the public university system. A chiropractic student in one country may not receive the same standard of education as one in a different country (2). For instance, chiropractic graduates from the university of Surrey in the United Kingdom receive a master of chiropractic degree as opposed to a doctorate degree (DC). In some countries without laws governing chiropractic, such as Germany, Honduras and Japan, there are a number of individuals, whom are simply part of the community, with limited formal technique instruction who are practicing as chiropractors (2). They are related to bonesetters of the past.

Much of the global growth and development in the chiropractic profession has been due to the increase in scientific literature being accomplished worldwide (3). The research has not only been vital to the continued growth and status of the chiropractic profession, but for gaining the respect and professional trust from others in the health care system. In the recent past, there has been a substantial increase in the quantity and quality of chiropractic research being published not only in North America, but also worldwide (2). This growth is crucial for the awareness of the chiropractic profession, and ultimately its success.

Organizations such as the WFC are extremely important for the chiropractic profession in many ways. It is evident that the profession has grown and united substantially in the last half century, however there still remains a significant void in various aspects worldwide. Chiropractic has been described as a profession that stands as at the crossroads of mainstream an alternative medicine. In order to continue this advancement in our profession, improvements need to be made with respect to the consistency (i.e. educational standards) of the profession on a global level. In this regard, the future of the chiropractic profession is in the hands of chiropractors themselves.