Chiropractors cannot advertise or hold themselves out as medical practitioners, said the Ministry of Health.

"Chiropractors, who are not registered medical practitioners under the Medical Registration Act (MRA), cannot practise medicine as doctors," said an MOH spokesman.

He was responding to The Sunday Times' queries on chiropractors who use "Dr" or "Doctor of Chiropractic" in their titles, which some customers say mislead them to assume that they are medical doctors.

"Patients and their caregivers are advised to exercise due diligence and consult appropriate healthcare practitioners for their medical problems. When in doubt, they should consult a registered medical practitioner," added the MOH spokesman.

However, chiropractors say that the "Dr" title is legitimate.

"'Doctor of Chiropractic' is the degree conferred by North American Chiropractic Institutions, and the honorific title used in Australia and other countries that do not confer a doctoral professional degree," said Dr Janet Ruth Sosna from Elder Chiropractic Clinic.

A new law was passed in 2011 to regulate allied health professionals, such as physiotherapists.

However, chiropractors were left out because they are alternative healthcare providers, then Health Minister Khaw Boon Wan said.

The Chiropractic Association said it would like to see the industry regulated.

"Singapore should follow Hong Kong, Malaysia and Thailand that have formally regulated chiropractic care in their countries. This can prevent rogues from entering Singapore to take advantage of an unregulated environment," said Mr Neil Stakes, vice-president of the association.

He added: "With the large practices that employ chiropractors who are recent graduates in a commission earning model, the care that is given is often without consideration of long-term best interests. Emphasis is made on completing the course of treatments so that another course can be prescribed."

Janice Tai