Why Some Doctors Distrust Chiropractors: What the Research Actually Says

By Dr. Jason Forward, DC. Practicing chiropractor in Tulsa, Oklahoma. Posted April 18, 2026.

A New Study on an Old Problem

On April 18, 2026, BMC Complementary Medicine and Therapies published a systematic review titled "Attitudes and perceptions of health care professionals concerning chiropractors and chiropractic practice" (Newell et al., 2026). The review examined published research on how doctors, nurses, and other healthcare professionals view chiropractors and chiropractic treatment.

This is a question that matters to patients. If your doctor tells you not to see a chiropractor, you want to know whether that advice is based on clinical evidence or something else entirely.

The fact that a peer-reviewed journal published this systematic review tells you the question is legitimate. Researchers do not spend months analyzing professional attitudes unless those attitudes have real consequences for patient care.

So let us look at the data. Not opinions. Not anecdotes. The actual published numbers.

The Safety Comparison: Putting the Numbers Side by Side

One of the most common reasons doctors discourage chiropractic care is safety concerns. "It is dangerous." "You could get hurt." "Stick with medication."

Here is what the published research actually shows when you compare annual deaths associated with common medical interventions to chiropractic care:

Read that table again. NSAID medications, the over-the-counter pills most people consider completely harmless, are associated with 16,500 deaths per year from gastrointestinal complications alone. Opioid overdoses killed over 80,000 Americans in 2024. Medical errors as a category represent the third leading cause of death in the United States.

Chiropractic care? 26 published deaths over a 32-year period from 1975 to 2007. That is less than one per year.

More recent data reinforces this. A 2023 study in Scientific Reports analyzed 960,140 chiropractic sessions and found a severe adverse event rate of 0.21 per 100,000 treatments. Zero deaths (Pohlman et al., 2023). A 2026 review in Chiropractic and Manual Therapies examined 25 studies covering over 400 adverse events and found no life-threatening events in any clinical study setting.

Nobody is saying medical care is unnecessary. Medical intervention saves lives every day. Emergency rooms, surgeries, and medications are essential parts of healthcare. But when a doctor tells a patient that chiropractic is "dangerous" while prescribing NSAIDs or opioids for musculoskeletal pain, the published safety data does not support that position.

And in 2026, Whedon et al. showed that among 291,604 Medicare patients with neck pain, chiropractic care was associated with approximately 20% fewer adverse events than prescription drug therapy and saved $435 per patient in hospital costs (Whedon et al., JMPT 2026).

Follow the Money: How Chiropractic Impacts Healthcare Revenue

If the safety data clearly shows chiropractic care carries minimal risk, and if clinical guidelines now recommend manual therapy as a first-line treatment for musculoskeletal pain, then why do some doctors not like chiropractors?

The financial data is worth examining. Every number below is sourced from published research.

Opioid prescriptions drop dramatically

Patients who see a chiropractor first for low back pain have 90% decreased odds of filling an opioid prescription compared to those who start with a medical provider. A 2022 study in Chiropractic and Manual Therapies found that chiropractic care reduced opioid prescription filling by 56% among Medicare beneficiaries (Whedon et al., 2022).

A 2025 study in PLOS ONE found that chiropractic management of sciatica was associated with 71% fewer opioid-related adverse events compared to standard medical management (PLOS ONE, 2025).

The US pharmaceutical industry generates over $600 billion in annual revenue. Opioid medications alone represent a multibillion-dollar market segment. When one profession reduces prescriptions by 56 to 90%, that is a measurable impact on revenue.

Surgery rates collapse

Washington State workers' compensation data showed that patients who saw a surgeon first for back pain had a 42% surgery rate. Patients who saw a chiropractor first? 2%.

Spinal surgery is among the highest-revenue procedures in the US healthcare system. The average lumbar fusion costs $50,000 to $100,000 or more. When chiropractic care routes patients away from surgery, the financial impact on surgical practices and hospitals is significant.

Total medical costs drop by thousands

Medicare patients who received chiropractic care spent an average of $8,848 less in total medical costs per episode compared to those who did not. That includes fewer imaging studies, fewer specialist referrals, fewer emergency department visits, and fewer hospitalizations.

Every one of those avoided costs represents revenue that would have gone to some other part of the healthcare system.

The Question Nobody Wants to Ask

Here is the uncomfortable question, and it deserves to be asked honestly:

If chiropractic care is demonstrably safe, clinically effective for musculoskeletal conditions, recommended by major medical guidelines, and dramatically less expensive than the alternatives, then what explains the persistent professional distrust?

Could financial incentives play a role in how some healthcare professionals view chiropractic care? The research published today in BMC Complementary Medicine and Therapies suggests this is a question worth examining.

This is not about accusing individual doctors of being greedy. Most physicians genuinely want what is best for their patients. The issue is systemic. When an entire healthcare economy is structured around medications, imaging, specialist referrals, and procedures, any profession that reduces the need for those things faces structural resistance.

The data raises important questions:

• If chiropractic care reduces opioid prescriptions by 56 to 90%, who benefits financially from discouraging patients from trying it first?
• If patients who see a chiropractor first have a 2% surgery rate versus 42% when seeing a surgeon first, how does that affect surgical practice revenue?
• If chiropractic patients spend $8,848 less in total medical costs, what does that mean for a healthcare system that generates revenue from services delivered?

These are not conspiracy theories. These are basic economic questions supported by published data. The Newell et al. systematic review being published today adds another layer by documenting how those attitudes actually manifest among healthcare professionals.

Where We Agree: Collaborative Care Works Best

The best patient outcomes happen when chiropractors and medical doctors work together. The data supports that clearly.

Chiropractic is not a replacement for medical care. If you are having a heart attack, you need an emergency room. If you have an infection, you need antibiotics. If you have cancer, you need oncology. Nobody in the chiropractic profession disputes that.

But for musculoskeletal pain, starting with conservative care produces better outcomes at lower cost with dramatically fewer risks. That is not a chiropractic talking point. That is what the American College of Physicians recommends. That is what the published research shows. And that is what every major clinical guideline for low back pain, neck pain, and headaches now reflects.

The ideal healthcare system would route musculoskeletal patients to conservative care first and escalate to medications and surgery only when needed. Some systems already do this. The Department of Veterans Affairs and the Department of Defense both include chiropractic care in their clinical pathways. Workers' compensation systems that use chiropractors as gatekeepers see lower costs and better outcomes.

The question is not whether collaborative care works. It does. The question is why the rest of the system has been slow to adopt it.

Dr. Jason's Take

I did not open a clinic to fight with MDs. I opened Vanguard Chiropractic because $40 adjustments help people avoid $50,000 surgeries. The data supports that.

I see patients every week who come in after months or years of medication management that did not fix their problem. They have been on muscle relaxants, NSAIDs, and sometimes opioids for pain that turned out to be a mechanical joint restriction. Something that responds to manual therapy in a handful of visits.

I do not have anything against medical doctors. I refer patients to them when the situation calls for it. Red flags, neurological deficits, conditions outside my scope. That is standard practice and it is non-negotiable.

But I do have a problem with a patient being told chiropractic is dangerous when the data shows it is one of the safest interventions available for musculoskeletal conditions. I have a problem with a patient being prescribed opioids for mechanical back pain when guidelines recommend manual therapy first. And I have a problem with professional attitudes that appear to be disconnected from the published evidence.

The systematic review published today is asking the right question. It is looking at what drives those attitudes. That conversation is long overdue.

If you are in Tulsa and you have been told not to see a chiropractor, I would encourage you to look at the research yourself. The links are all in this article. Read the studies. Look at the safety numbers. Then make your own decision.