Friends don't let friends become chiropractors

And especially not if they work on babies.

So I had a long road trip today and hit the podcasts, as usual. And I heard an ad that was new to me, and it was for a leading chiropractic school¹ in the US.

The ad hit all the points you’d expect from a medical school:

1. It’s accredited;

2. It’s focused on evidence-based medical care;

3. Graduates can become board-certified;

and blah blah blah. All stuff that sounds perfectly legit and impressive, and might well deceive a young person into attending in hopes of becoming a medical professional.

They would be disappointed in the results.

Only one of those three points is not misleading or false, and that’s that top chiropractic schools are legitimately accredited. For a long time they weren’t, and the profession had to invent their own accreditation bodies in order to self-accredit and convincingly deceive students and chiropractic patients. Accreditation of universities — which allows them to grant legit degrees and allows their students to access federal student loans — is handled by the US Department of Education and also by an NGO called the Council for Higher Education Accreditation (CHEA). (And it’s reasonable to point out that we don’t really know how much longer the USDE will continue this role under the current education-hostile administration.)

CCE, the primary board that accredits chiropractic universities in the US, has been recognized since 1974. So the school I heard advertise on the podcast is, in fact, legitimately accredited. But here’s the thing. What that means is that their education programs are legit and meet standards — it says nothing about whether chiropractic is real medical care or magical woo (spoiler alert: it’s magical woo).

This brings us to point #2 above. The American Medical Association is the body in charge of recognizing medical specialties as legit or not. Chiropractic is not a recognized medical specialty. Why not? Here’s why:

• Insufficient Scientific Evidence for Core Claims. The foundational chiropractic principle of “vertebral subluxation complex” — that spinal misalignments cause disease by interfering with the “flow” of a conjectural “energy field” called “innate intelligence” — lacks empirical validation and contradicts established neurophysiology. Systematic reviews demonstrate no convincing evidence that chiropractic adjustments can treat systemic diseases, infections, or non-musculoskeletal conditions. Meta-analyses show effect sizes are typically small and rarely exceed placebo or conventional physical therapy outcomes.​ The one exception is that some lower back pain can be successfully treated by some chiropractic methods; it’s really just a physiotherapy massage and you’re better off getting it from a CMT who is licensed to provide it legally.

• Significant Safety Risks with Inadequate Risk-Benefit Ratio. Cervical spine manipulation carries a very real risk of catastrophic adverse events, including vertebral artery dissection leading to stroke and death. Large-scale studies estimate severe adverse events occur in 0.21-1 per 100,000 manipulations, with cervical artery dissection risk estimated at 1-3 per 100,000. While proponents argue these risks are rare, the medical establishment notes that no other legitimate medical intervention with such severe potential complications would be accepted without robust informed consent protocols and necessity justification — particularly when safer alternatives (physical therapy, exercise) exist for the same conditions.​

  • These numbers are substantially more alarming for infants, with cases of subarachnoid hemorrhage leading to death, cervical spine fracture resulting in death, clavicular fractures, paraplegia, neurological deficits, rib fractures, and respiratory decompensation. No systemic review has ever found any evidence of benefit for chiropractic care on infants; it is pure risk only.

• Substantially Inferior Education and Training Requirements. Doctor of Chiropractic programs require approximately 4,200 instructional hours with no residency requirement. By contrast, MD/DO physicians complete 12,000-16,000+ hours of clinical training plus 3-7 years of residency. Chiropractic students receive minimal training in pharmacology, emergency medicine, differential diagnosis of complex conditions, and critical care — leaving them unprepared to recognize life-threatening conditions or manage medical emergencies. The AMA explicitly states chiropractors lack “the level of subsequent training that MD and DO medical students receive” and are “not physicians”.​ Unfortunately, due to decades of successful marketing by the profession, many people think chiropractors are “back doctors.”

• AMA and Medical Specialty Boards Explicitly Reject Equivalence. The AMA maintains that chiropractors are “not physicians” and actively opposes legislation that would grant them physician status or expanded Medicare scope. In a 2025 letter to Congress, 11 major medical specialty societies (including neurology, orthopedics, and physical medicine) warned that expanding chiropractic scope would “put patient safety at risk” and create “false expectations regarding the care they receive”. The AMA’s position reflects the consensus that chiropractic training does not meet the standards for unlimited medical licensure.​

• Restricted Scope of Practice and Legal Limitations. Chiropractors face explicit statutory restrictions prohibiting them from practicing surgery, prescribing medications, delivering babies, or treating conditions requiring pharmaceutical intervention. State practice acts vary widely — some prohibit chiropractors from using the title “physician” entirely. This legal framework reflects legislative judgment that chiropractic training is insufficient for independent medical practice. Unlike physical therapists who operate under physician referral, chiropractors function as limited-scope practitioners without the diagnostic breadth or therapeutic versatility required for comprehensive patient care.​

And that brings us to #3, that students can become chiropractors and get “board certified.” Well, yes, they can; by the industry’s own made-up self-certification board because the AMA will not grant that privilege to wooists.

The primary credentialing body is the National Board of Chiropractic Examiners (NBCE), created by the industry itself in 1963. And there are a ton of other ones. The chiropractic industry seems to in-fight a lot and cranks out competing licensing boards like Guido cranks out pasta. These include:

ABCS, DABCA, DABCI, DCBCN, DABCP, DACBR, DACNB, DACBSP, FCLB, RCSP, and probably a bunch of others I’m missing. I was going to add links to each of those, but that’s a pain in the ass, and if you really want to visit each you can copy-and-paste them into Google yourself. 😃

So, yes; strictly speaking, a graduate from a chiropractic school can become board certified, but it’s by a silly board that is not recognized by the medical profession — so that claim in the ad was misleading at best. Although I’m sure the little framed certification looks very convincing on the chiropractor’s wall.

1. An oxymoron, as you’ll see from the rest of this post.