Choosing a Career in the Health Care Field

From Our Mailbag:

Dear Dr. Kim,

I have been receiving your weekly newsletter for several months now and would like to ask you for some advice on choosing a career in the natural health field. I can't decide between chiropractic, naturopathy, traditional medicine, and oriental medicine.

I know you are busy, but if possible, could you share your thoughts on what you would choose if you were to do it all over again?

Thank you very much,

Jen Davis
Salem, Oregon

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Dear Jen,

Of the four professions that you mentioned, the one that I am most qualified to tell you about is chiropractic.

In the States, the scope of chiropractic practice varies widely from state to state. In Oregon, chiropractors are licensed to perform many of the duties that are typically in the domain of family medical doctors, including minor surgery. On the other end of the spectrum, in states like Washington and Michigan, chiropractors are primarily considered to be musculoskeletal specialists who focus on treating disorders related to the spine.

The scope of your career as a chiropractor may be influenced significantly by the school that you attend. Schools like the National University of Health Sciences in Illinois (my alma mater), Western States Chiropractic College in Oregon, Los Angeles Chiropractic College, Palmer College of Chiropractic in San Jose, and Northwestern Health Sciences University in Minnesota will provide you with a strong foundation in basic and clinical sciences, one that will allow you to work confidently with health care providers in almost any other field. My apologies to other schools that provide educational programs similar to the schools listed above that I don't know about - I'm sure that there are some out there.

Schools that focus primarily on chiropractic philosophy, namely, the concept that chiropractic adjustments are absolutely essential to proper nerve flow (sometimes called life force) throughout your body, may not provide you with as strong a foundation in basic and clinical sciences as the schools mentioned above.

Personally, I'm grateful that I went to a school that gave me the opportunity to develop a strong background in basic and clinical sciences. If I were to do it all over again, I would go to one of the five schools listed above.

As I mentioned in an article that I wrote last year on the merits of spinal adjustments, many people who attend chiropractic school do not go on to practice chiropractic.

Unless you have an existing relationship with an established chiropractor or are well funded, it may be difficult to get started. It is not uncommon for many chiropractors to carry tens of thousands of dollars in school debt many years after they graduated. Make no mistake about it: it can be extremely hard to establish yourself as a chiropractor in and around a major city.

Being a chiropractor does provide many opportunities to help others with their health. If you are serious about becoming a chiropractor, I think that the ideal scenario is to practice in an area that truly needs chiropractic services. You will probably need to do some research to find such an area, as most major cities now have more chiropractors than their populations need, a scenario that has resulted in heavy competition and pressure on some struggling chiropractors to do whatever they can to attract and keep patients - not an ideal environment for providing the same care to one's patients as one would to his or her own family.

Since I am not a medical doctor, I cannot provide any reliable feedback on what it's like to be one. However, I think it's quite clear that medical doctors command more respect from the general public, government, and health insurance companies than chiropractors and other health care providers do. The state medical board that oversees your practice may have problems with you promoting certain natural therapies as a medical doctor.

Medical doctors pay much more in malpractice insurance than chiropractors, naturopaths, and other alternative health care practitioners. A friend of mine who is a family medical doctor pays approximately $16,000.00 per year in malpractice insurance. A friend of my father's who practices psychiatry in upstate New York pays $50,000.00 per year. Most chiropractors in the States and Canada pay approximately $2,500.00 to $3,500.00 per year in malpractice insurance.

As a medical doctor, you are not likely to struggle to find patients to help, as the government and health insurance companies provide a wide range of coverage for medical services.

Chiropractors are licensed in all 50 states and do receive some recognition from government-assisted programs and health insurance companies, but there are usually many hoops to jump through and the coverage is nowhere close to being as extensive as it is for medical doctors.

My understanding is that most naturopaths and doctors of oriental medicine have cash practices since the government and insurance programs don't provide much coverage for their services. This is a real shame, in my opinion, since some of the most competent and caring health care professionals that I have met over the years are naturopaths and acupuncturists.

A profession that I would seriously consider getting into if I were to do it all over again is midwifery. Throughout the course of my wife's first pregnancy and the home delivery of our baby last summer, we had the opportunity to work with three midwives. I was deeply impressed by their dedication to helping parents give newborns the healthiest possible start in life. Our health begins in our mothers' minds and bodies even before we begin growing in their wombs, a fact that midwives seem to embrace and know more about than any other health care professionals.

The only downside that I have observed of the life of a midwife is his or her grueling schedule. On one occasion when we had to call our primary midwife at 3 am, we felt terrible as the phone was ringing, thinking that we were about to wake her, but were surprised when she answered our call on her cell phone while she was driving home from a late night housecall.

Here in Ontario, midwifery care is paid for in full by the government.

Well, I think that just about covers most of what I have to write in response to your question about choosing a career in the health care field. Good luck, Jen!

Ben Kim