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Chiropractic Care for Children
Anne CC Lee, BSE;
Dawn H. Li, MD;
Kathi J. Kemper, MD, MPH
Arch Pediatr Adolesc Med. 2000;154:401-407.
Objective To describe the practice characteristics and pediatric care of chiropractors.
Study Design Cross-sectional, descriptive survey.
Setting Chiropractic practices in the Boston, Mass, metropolitan area.
Participants One hundred fifty licensed chiropractors.
Main Outcome Measures Demographics, practice characteristics, and fee structure. Practitioners were also asked about their approach to childhood immunizations and a clinical scenario. Data were analyzed using simple descriptive statistics.
Results Ninety (60%) chiropractors responded. All were white and 65% were men. Respondents had on average 122 patient visits weekly, of which 13 (11%) were from children and adolescents. Typical visit frequency ranged from 1 to 3 times weekly. Average visit fees were $82 and $38 (initial and follow-up) and 49% of the fees were covered by insurance. Seventy percent of the respondents recommended herbs and dietary supplements. For pediatric care, 30% reported actively recommending childhood immunizations; presented with a hypothetical 2-week-old neonate with a fever, 17% would treat the patient themselves rather than immediately refer the patient to a doctor of medicine, doctor of osteopathy, or an emergency facility.
Conclusions Children and adolescents constitute a substantial number of patients in chiropractics. An estimated 420,000 pediatric chiropractic visits were made in the Boston metropolitan area in 1998, costing approximately $14 million. Pediatric chiropractic care is often inconsistent with recommended medical guidelines. National studies are needed to assess the safety, efficacy, and cost of chiropractic care for children.
From the Harvard Medical School, Boston, Mass (Ms Lee and Dr Kemper); Columbia Medical School, New York, NY (Dr Li); and Children's Hospital, Boston (Dr Kemper).
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