What is a Board Certified Chiropractic Orthopedist?

Written by: James Demetrious, DC, DABCO

Diplomate, American Board of Chiropractic Orthopedists
Diplomate, International Academy of Neuromusculoskeletal Medicine

What is a Board Certified Chiropractic Orthopedist?

A chiropractic orthopedist is a physician with advanced training in complex neuromusculoskeletal medical assessment, imaging, orthopedics, rheumatology, musculoskeletal trauma, rehabilitation, systemic differential diagnosis, and the non-surgical care of the CNS, spine, and extremities.

Chiropractic orthopedists are primary spine physicians uniquely qualified to diagnose, treat, and coordinate ancillary medical care for neuromusculoskeletal conditions.

Less than 1% of all chiropractors have achieved this high level of clinical competence.

Why I Become a Board-Certified Chiropractic Orthopedist

My very first patient in chiropractic school sought care for lower back pain. She was diagnosed with breast cancer 20 years prior. While in remission, she underwent annual oncologic assessments. She brought recent bone scintigraphy images and the corresponding radiology report to me for review. Her attending medical radiologist indicated no increased uptake or metastatic disease.

Upon reading the bone scan, I noticed a small foci of increased uptake mid-sacrum. I presented my findings to the clinic director and attending radiologist. They confirmed that there was a problem and we referred the patient back to her oncologist. Sadly, her oncologist confirmed metastatic breast cancer to the sacrum.

During this formative period of my training, this incident confirmed to me the importance of my studies and improving my clinical competence.

Advanced Postgraduate Training

Shortly after graduating from chiropractic school, I began and completed the live 360-hour chiropractic orthopedic board certification coursework through National Chiropractic College and passed stringent national board examinations.

The chiropractic orthopedic program through National was taught by top doctors in their respective fields. All 360 hours of coursework were live and hands-on. Every learning module began with an anatomic review of cadaveric specimens with a Ph.D. from the University of Chicago Medical School.

Our coursework was advanced with an emphasis on evidence-based clinical assessment.

Additional Preceptor Training and a Lifetime of Study

Early in practice, the wife of a local medical orthopedist sought my care for terrible migraines. I was able to alleviate her pain. In gratitude, the surgeon befriended me and invited me to observe hundreds of surgeries. I shadowed him in his office and he kindly served as a preceptor and mentor to me for many years. He introduced me to local neuroradiologists and physicians who allowed me to shadow them in practice.

Of necessity, I continue to read the literature daily, publish papers and apply what I’ve learned for my patients’ benefit since 1986.

How Can We Elevate our Clinical Competence and Help Heal the World?

In the biography “The Journey of Scott Haldeman” (Phillips – 2009), Dr. Haldeman recommends the development of a “Primary Spine Care Specialist.” [1] It is my opinion that the chiropractic orthopedic physician is best suited to serve this important role to:

— Evaluate, order, and interpret advanced imaging/lab work, develop complex differential diagnoses and refer patients for ancillary medical care when necessary.

— Provide highly skilled chiropractic HVLA-SMT and care.

— Carefully discuss patient needs, benefits and consensus appropriateness criteria for chiropractic and medical ancillary care.

— Assess the impact of treatment, discontinue ineffective treatment, and make alternative recommendations.

— Inform and educate patients related to activities of daily living.

— Establish the confidence of patients and colleagues with a higher level of competence.

— Navigate complex medical diagnoses and systems that can hinder patients’ response to treatment.

How Can We Become Truly Great Doctors?

We elevate ourselves and our profession through advanced training, diligence, and deference to our patients. This requires consistency and dedication to a lifetime of learning. We must seek out the very best continuing education and learning opportunities to improve ourselves daily.


At PostGradDC, we have dedicated ourselves to the advancement of the chiropractic profession. We seek to protect and defend our patients from the adverse effects of unnecessary, risky, and wasteful care. We choose continual study to help our patients improve their quality of life. We serve to protect and promulgate the chiropractic profession and its doctors.


1.) Phillips R. The Journey of Scott Haldeman. NCMIC; 2009: 453-455.


The views and opinions expressed in this presentation are solely those of the author. The information is not offered as a standard of care as research and care evolve. We offer this only to educate and inform. Patients should seek the care of their doctors regarding their conditions.

For advanced PACE-recognized CE, go to PostGradDC.com.

PostGradDC offers advanced post-graduate chiropractic continuing education. Our founder, Dr. James Demetrious, is an internationally distinguished board-certified chiropractic orthopedist, educator, author, and editor. For current, evidence-based, and clinically intuitive CE Coursework, attain your advanced training at PostGradDC.com.