Most families have a general practitioner or family physician who acts as a primary care provider. This means that they oversee and manage the internal and external health concerns of a given patient. If there is further evaluation they may need in a specialty, they will then refer them to a specialist. Some families may have a family chiropractor as well. A family chiropractor may be a first contact provider of healthcare for one or more members in a given family. Specifically, a family chiropractor will utilize their knowledge, skills and decision-making abilities to oversee the needs of a family’s health. They may order tests including lab testing and/or imaging, perform a history and evaluation, and refer for further evaluation from a specialty outside of their scope and expertise much the same way as a family physician (MD or DO) will do. A family chiropractor may do all of the things an MD will do save for writing prescriptions for medications and performing surgery. The scope of a family chiropractor will also vary from state to state in what they are allowed to do even outside of the above mentioned attributes.
The initial intake will include a history, past medical history, present illness, family history, medication history list, social history and testing history followed by an examination. The decision-making process by the family chiropractor is quite similar to the medical physician counterpart. Where they will diverge in triage will be in the treatment, for the most part. Both a family physician and a chiropractor are trained in differential diagnosis. The differential diagnosis is a list of possible diagnoses based upon the information gathered during the initial visit. A chiropractor will formulate a treatment plan with short and long term goals, based upon improvements and measures from the gathered information in the examination portion of the initial intake, which is the standard treatment from a given list of differentials. This includes objective measures and tests (orthopedic, neurological, range of motion, etc.) which will determine the need for improvement and this will influence the length of a given treatment plan which will take place in a chiropractor’s office. The treatment may include physical conservative modalities, mobilization, manipulation, soft-tissue techniques, stretching and rehabilitative exercises, and more depending upon the focus of a practice. In general, this differs from a family physician’s treatment plan who will decide on needed medications and referral for further treatment possibly in a chiropractor’s office or by a physical therapist for the treatment of injuries or ailments that are musculoskeletal in nature. A family chiropractor is well-equipped and educated to handle the evaluation and triage of a given illness in myriad age groups. An example of this would be a chiropractor, as reported in a case report, after seeing a 16 year old male patient who had hip pain 18 months in duration, viewed an x-ray of his hips and detected SCFE, which is a common adolescent congenital condition which requires surgery. He referred this patient back to his primary care physician (who ordered the original films and concluded them as unremarkable) who then recommended this patient for surgery. This study encapsulates the importance that a chiropractor may play in the health management team of a given family.
Reference Cited in this Article
Slipped capital femoral epiphysis (SCFE) detected in a chiropractic office: as case report. J Can Chiropractor Assoc 2009 Aug; 53(3):158-64
Differential Diagnosis and Management for the Chiropractor: Protocols and Algorithms (2nd Edition)
Role of Patient History and Physical Examination in the: Differential Diagnosis http://www.medscape.com/viewarticle/505376_7
Get more information on the first chiropractic visit.