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Specialization Isn’t Just for Insects… or MDs

by on November 16, 2012
Graph showing increased specialization of active doctors 1996-2006

Figure 1. This 2008 data from the Association of American Medical Colleges shows a number of specialty medical practices (blue) outpacing growth in more general primary care (red) and especially general surgery, which shrunk.1

In the book Time Enough for Love by Robert Heinlein, protagonist Lazarus Long famously expresses the sentiment, “Specialization is for insects.”

Clearly he did not spend much time in modern medical schools.

The website of the American Medical Association (AMA) lists 110 medical specialty organizations that it formally recognizes, but the actual number of areas that doctors may claim as a specialty number in the thousands. Data from the American Association of Medical Colleges (AAMC) shows a trend toward increased specialization, which may be driven by factors such as higher pay among many specialists or possible
performance benefits resulting from systems of specialists.

The chiropractic profession has also seen increased interest in specialization. The American Chiropractic Association (ACA) has councils to reflect these subspecialties, which offer diplomate programs providing advanced training in ten areas:

  • Chiropractic Pediatrics
  • Chiropractic Physiological Therapeutics and Rehabilitation
  • Chiropractic Acupuncture
  • Diagnosis and Internal Disorders
  • Diagnostic Imaging (Radiology)
  • Neurology
  • Nutrition
  • Occupational Health
  • Sports Physician
  • Orthopedics

Several chiropractic schools also offer master’s degrees to develop even more honed professionals. An MS in Nutrition is a common offering, and other interesting options include Palmer College of Chiropractic’s Chiropractic Research degree, and New York Chiropractic College’s MS of Human Anatomy and Physiology Instruction.

A recent article released by the ACA indicates ongoing evolution of the post-graduate education and certification of chiropractic subspecialists. It will be interesting to see the changes that are made, and the resulting relationships and systems that develop among practicing chiropractors and fellow health practitioners.

As a chiropractic student currently entrenched in the basic studies that many of these specialties use as a foundation, a good 50% of the advanced study options sound fascinating and appealing. As in any realm of medicine, the learning seems never to end.

In Time Enough to Love, Heinlein’s character Lazarus goes on to say, “A human being should be able to change a diaper, plan an invasion, butcher a hog, conn a ship, design a building, write a sonnet, balance accounts, build a wall, set a bone, comfort the dying, take orders, give orders, cooperate, act alone, solve equations, analyze a new problem, pitch manure, program a computer, cook a tasty meal, fight efficiently, die gallantly.”

So who’s to say you can only have one specialty?


Graphic data source:

2008 Physician Specialty Data. Association of American Medical Colleges. 2008: p. 24. Available at: Accessed November 16, 2012.

More on specialties:

ACA Specialties:

AMA Specialties:

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Dr Tamara Lovelace

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