Chiropractic 2025:

The Figure below identifies various terms used for these chiropractic communities:
Chiropractic Communities
Liberal Conservative
Pragmatic Philosophical
Mixer Straight
Broad-scope Middle-scope Focused-scope
Chiropractic 2025: Divergent Futures
The last row of categories were used in Chiropractic Peace, a book edited by William McDonald, DC, MSEd, that
includes chapters authored by leaders from the three practice philosophies—Gerard Clum, DC (focused-scope),
Ashley E. Cleveland, DC, MA (middle-scope), and Reed B. Phillips, DC, PhD (broad-scope). Based on Chiropractic
Peace, the categories can be described as follows:
■ Focused-scope: detects and adjusts vertebral subluxations to restore normal nerve function, i.e., provides care
toward the overall wellbeing of the patient, as opposed to the treatment of a given condition
■ Middle-scope: combines subluxation adjusting with other conservative treatment and diagnostic procedures
■ Broad-scope: uses a wide array of manual and other procedures to diagnose and treat conditions that expand
beyond the typical musculoskeletal, orthopedic, and neurological examinations; many favor being able to prescribe
medicines
Not all chiropractors are familiar with this book and these groupings, and some may even feel offended by the terms
(e.g. many focused-scope practitioners do not believe their scope is focused or narrow, even if they believe that
subluxation is real; and some chiropractors are unhappy with “middle-scope” as not having any meaning). In the
second row of the chart above, “philosophical” chiropractors refers to those who believe that correcting/removing
subluxations provides spine health and enables the nervous system to convey the body’s self-healing capacities
to all parts of the body. They believe that there is vital life force behind this self-healing capacity, and many think
that the “why” of chiropractic is more important than “what” chiropractors do. Chiropractors use manipulation to
alleviate subluxations, foster self-healing, and create optimal health. “Pragmatic” chiropractors provide effective
manipulation and related services on the basis of their effectiveness in dealing with the patient’s conditions.
“Conservative,” in the first row, can describe “straights” or those who only provide adjustments to treat subluxation,
and do not treat conditions. Yet “conservative” and “natural” are terms most chiropractors would prefer in describing
their chiropractic care, regardless of the community to which they belong. Given these possibilities for naming the
communities, we frequently use the focused-scope, middle-scope, and broad-scope terminology used in Chiropractic
Peace. As relevant in this report, we will also call the focused-scope community philosophical chiropractors if that
better suits the discussion at hand. Though we recognize that all three communities are philosophical, we have also
found that the focused-scope community can be more fundamentalist in owning and describing their philosophy.
We also recognize that there is diversity within each of the three dominant communities on the spectrum. For
example, within the broad-scope community, there are three main themes of focus, including 1) gaining prescription
rights in order to better meet primary care demands, particularly in rural areas; 2) treating non-neuromusculoskeletal
conditions conservatively without prescription rights; and 3) focusing on neuromusculoskeletal conditions with
prescription rights.
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