{
  "source": "Cooked Index — occupational AI risk register",
  "page": "https://cookedindex.com/jobs/chiropractors/",
  "methodology": "https://cookedindex.com/methodology",
  "notice": "Verdicts are re-examined as evidence accumulates. Re-fetch before relying on this; the page above always carries the current score.",
  "scored_at": "2026-08-11",
  "model": "claude-opus-5",
  "occupation": {
    "title": "Chiropractors",
    "soc_code": "29-1011",
    "category": "Healthcare",
    "us_employment": 39630,
    "median_annual_wage": 79200
  },
  "verdict": "SAFE",
  "risk_resistance": 79,
  "contested": false,
  "near_boundary": false,
  "dimensions": {
    "task_resistance": 15,
    "embodiment": 18,
    "liability_shield": 17,
    "trust_premium": 16,
    "judgment_accountability": 13
  },
  "reasoning": {
    "task_resistance": "The billable act — locating a restricted segment by palpation, setting a line of drive, and delivering a high-velocity low-amplitude thrust with the patient's tone and guarding shifting between passes — is the visit, and it sits at 15 rather than 18 because the surrounding tier (history intake, Medicare-compliant SOAP documentation, CPT 98940-98942 coding, ROF scripts, recall scheduling) is a real fraction of your week and is already being handled by software.",
    "embodiment": "An 18 reflects that you are bodily loaded into the work — drop-table, Gonstead, Activator, side-posture lumbar rolls, cervical setups on necks with variable range — on patients whose size, pain tolerance, and osteoporotic risk are never standardized, in a room where an unexpected flinch mid-thrust is your problem to absorb.",
    "liability_shield": "Every state licenses DCs through a board with its own scope statute and NBCE Part I-IV plus physiotherapy requirements, you carry your own malpractice policy, and cervical manipulation with stroke and VBA-dissection allegations is litigated against you by name — that's a 17, held short of 20 only because scope excludes prescribing and most surgical exposure.",
    "trust_premium": "Chiropractic runs on repeat visits and word-of-mouth referral in a way most medicine doesn't — patients pick a specific adjuster, often cash-pay or out of a limited annual visit cap, and will follow that person across town; 16 rather than 19 because a share of the caseload arrives via PI attorney referral or plan networks where the relationship starts transactional.",
    "judgment_accountability": "13 sits at the top of real discretion: you decide when neck pain with headache and nystagmus is a contraindication, when radiating leg pain means MRI and an ortho referral rather than a fourth adjustment, and when to stop care — high-stakes calls, but made against established red-flag screening frameworks rather than in true diagnostic wilderness."
  },
  "rationale": "The core of the job is manual spinal and joint manipulation performed with hands on a live patient whose tissue response changes minute to minute — nothing in current robotics comes close. AI can absorb the paperwork tier: intake histories, SOAP notes, insurance coding, X-ray pre-reads, and generic home-exercise handouts. What remains is a licensed clinician who palpates, adjusts, decides when a case is a red flag needing MD referral, and owns that call.",
  "outlook": "Chiropractic work stays hands-on and licensed through the 2030s; the pressure shows up as AI-driven triage apps and exercise chatbots skimming off the mildest, self-limiting cases and squeezing cash-pay volume at the low end.",
  "what_would_raise_it": {
    "levers": [
      {
        "dimension": "judgment_accountability",
        "change": "State board or malpractice-insurer rules making the DC personally responsible for documented red-flag screening (vertebral artery dissection, cauda equina, undiagnosed malignancy) before any cervical manipulation — NCMIC (the dominant chiropractic malpractice carrier) already conditions coverage on informed-consent and screening documentation; tightening this to a mandatory signed differential-diagnosis step per new patient shifts the role's weight onto the referral/no-adjust call",
        "plausibility": "plausible",
        "would_add": 3
      },
      {
        "dimension": "task_resistance",
        "change": "Task-mix shift: once AI reliably handles intake summarization, SOAP notes, CPT/ICD coding and imaging pre-reads (already shipping in chiropractic EHRs like ChiroTouch/Jane), the residual day is palpation, adjustment, and referral judgment — the automatable tier is the tier that leaves",
        "plausibility": "already happening",
        "would_add": 3
      },
      {
        "dimension": "liability_shield",
        "change": "Expansion of state scope-of-practice statutes that reserve spinal manipulative therapy to licensed DCs, DOs, or PTs with certification — plus board rules barring unlicensed 'adjustment' devices or technician-delivered manipulation under remote supervision. Watch state chiropractic board actions against non-licensee manipulation and any Medicare rule tying manipulation reimbursement to the treating licensee's own hands",
        "plausibility": "plausible",
        "would_add": 2
      },
      {
        "dimension": "trust_premium",
        "change": "Chiropractic is already largely cash-pay or partially self-pay, and patients choose a specific practitioner's hands; a further shift toward membership/cash models (as insurance manipulation coverage stays capped) hardens the paid-for-a-human component",
        "plausibility": "already happening",
        "would_add": 2
      }
    ],
    "ceiling_note": "Already near the top of the register; the score is carried by embodiment and licensure, so realistic movement is a few points of consolidation, not a category change. The genuine downside risk is not automation of the adjustment but payer pressure and PT/DO scope competition shrinking the occupation's size."
  },
  "adjudication": null,
  "employment_history": {
    "points": [
      {
        "y": 2017,
        "emp": 33630,
        "wage": 68640
      },
      {
        "y": 2018,
        "emp": 34740,
        "wage": 71410
      },
      {
        "y": 2019,
        "emp": 35010,
        "wage": 70340
      },
      {
        "y": 2020,
        "emp": 34760,
        "wage": 70720
      },
      {
        "y": 2021,
        "emp": 35810,
        "wage": 75000
      },
      {
        "y": 2022,
        "emp": 37740,
        "wage": 75380
      },
      {
        "y": 2023,
        "emp": 41480,
        "wage": 76530
      },
      {
        "y": 2024,
        "emp": 37630,
        "wage": 79000
      },
      {
        "y": 2025,
        "emp": 39630,
        "wage": 79200
      }
    ],
    "from": 2017,
    "to": 2025,
    "change_pct": 17.8,
    "comparable_from": 2019,
    "spans_soc_revision": true
  },
  "pivots": [],
  "license": "https://cookedindex.com/terms"
}