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Johnson, Claire D., and Bart N. Green. "Looking back at the lawsuit that transformed the chiropractic profession part 4: Committee on Quackery." Journal of Chiropractic Education 35, S1 (September 1, 2021): 55–73. http://dx.doi.org/10.7899/jce-21-25.
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Objective This is the fourth article in a series that explores the historical events surrounding the Wilk v American Medical Association (AMA) lawsuit, in which the plaintiffs argued that the AMA, the American Hospital Association, and other medical specialty societies violated antitrust law by restraining chiropractors' business practices. The purpose of this article is to provide a brief review of the history of the origins of AMA's increased efforts to contain and eliminate the chiropractic profession and the development of the Chiropractic Committee, which would later become the AMA Committee on Quackery. Methods This historical research study used a phenomenological approach to qualitative inquiry into the conflict between regular medicine and chiropractic and the events before, during, and after a legal dispute at the time of modernization of the chiropractic profession. Our methods included obtaining primary and secondary data sources. The final narrative recount was developed into 8 articles following a successive timeline. This article is the fourth of the series that explores the origins of AMA's increased efforts to contain and eliminate the chiropractic profession. Results In the 1950s, the number of chiropractors grew in Iowa, and chiropractors were seeking equity with other health professions through legislation. In response, the Iowa State Medical Society created a Chiropractic Committee to contain chiropractic and prompted the creation of the “Iowa Plan” to contain and eliminate the chiropractic profession. The AMA leadership was enticed by the plan and hired the Iowa State Medical Society's legislative counsel, who structured the operation. The AMA adopted the Iowa Plan for nationwide implementation to eradicate chiropractic. The formation of the AMA's Committee on Chiropractic, which was later renamed the Committee on Quackery (CoQ), led overt and covert campaigns against chiropractic. Both national chiropractic associations were fully aware of many, but not all, of organized medicine's plans to restrain chiropractic. Conclusion By the 1960s, organized medicine heightened its efforts to contain and eliminate the chiropractic profession. The intensified campaign began in Iowa and was adopted by the AMA as a national campaign. Although the meetings of the AMA committees were not public, the war against chiropractic was distributed widely in lay publications, medical sources, and even chiropractic journals. Details about events would eventually be more fully revealed during the Wilk v AMA trials.
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Johnson, Claire D., and Bart N. Green. "Looking back at the lawsuit that transformed the chiropractic profession part 8: Judgment impact." Journal of Chiropractic Education 35, S1 (September 1, 2021): 117–31. http://dx.doi.org/10.7899/jce-21-29.
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Objective This paper is the eighth in a series that explores the historical events surrounding the Wilk v American Medical Association (AMA) lawsuit in which the plaintiffs argued that the AMA, the American Hospital Association, and other medical specialty societies violated antitrust law by restraining chiropractors' business practices. The purpose of this paper is to discuss the possible impact that the final decision in favor of the plaintiffs may have had on the chiropractic profession. Methods This historical research study used a phenomenological approach to qualitative inquiry into the conflict between regular medicine and chiropractic and the events before, during, and after a legal dispute at the time of modernization of the chiropractic profession. Our methods included obtaining primary and secondary data sources. The final narrative recount was developed into 8 papers following a successive timeline. This paper is the eighth of the series that discusses how the trial decision may have influenced the chiropractic that we know today in the United States. Results Chiropractic practice, education, and research have changed since before the lawsuit was filed. There are several areas in which we propose that the trial decision may have had an impact on the chiropractic profession. Conclusion The lawsuit removed the barriers that were implemented by organized medicine against the chiropractic profession. The quality of chiropractic practice, education, and research continues to improve and the profession continues to meet its most fundamental mission: to improve the lives of patients. Chiropractors practicing in the United States today are allowed to collaborate freely with other health professionals. Today, patients have the option to access chiropractic care because of the dedicated efforts of many people to reduce the previous barriers. It is up to the present-day members of the medical and chiropractic professions to look back and to remember what happened. By recalling the events surrounding the lawsuit, we may have a better understanding about our professions today. This information may help to facilitate interactions between medicine and chiropractic and to develop more respectful partnerships focused on creating a better future for the health of the public. The future of the chiropractic profession rests in the heads, hearts, and hands of its current members to do what is right.
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Johnson, Claire D., and Bart N. Green. "Looking back at the lawsuit that transformed the chiropractic profession part 7: Lawsuit and decisions." Journal of Chiropractic Education 35, S1 (September 1, 2021): 97–116. http://dx.doi.org/10.7899/jce-21-28.
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Objective This is the seventh paper in a series that explores the historical events surrounding the Wilk v American Medical Association (AMA) lawsuit in which the plaintiffs argued that the AMA, the American Hospital Association, and other medical specialty societies violated antitrust law by restraining chiropractors' business practices. The purpose of this paper is to provide a summary of the lawsuit that was first filed in 1976 and concluded with the final denial of appeal in 1990. Methods This historical research study used a phenomenological approach to qualitative inquiry into the conflict between regular medicine and chiropractic and the events before, during, and after a legal dispute at the time of modernization of the chiropractic profession. Our methods included obtaining primary and secondary data sources. The final narrative recount was developed into 8 papers following a successive time line. This paper, the seventh of the series, considers the information of the 2 trials and the judge's decision. Results By the time the first trial began in 1980, the AMA had already changed its anti-chiropractic stance to allow medical doctors to associate with chiropractors if they wished. In the first trial, the chiropractors were not able to overcome the very stigma that organized medicine worked so hard to create over many decades, which resulted in the jury voting in favor of the AMA and other defendants. The plaintiffs, Drs Patricia Arthur, James Bryden, Michael Pedigo, and Chester Wilk, continued with their pursuit of justice. Their lawyer, Mr George McAndrews, fought for an appeal and was allowed a second trial. The second trial was a bench trial in which Judge Susan Getzendanner declared her final judgment that “the American Medical Association (AMA) and its members participated in a conspiracy against chiropractors in violation of the nation's antitrust laws.” After the AMA's appeal was denied by the Court of Appeals for the Seventh Circuit in 1990, the decision was declared permanent. The injunction that was ordered by the judge was published in the January 1, 1988, issue of the Journal of the American Medical Association. Conclusion The efforts by Mr McAndrews and his legal team and the persistence of the plaintiffs and countless others in the chiropractic profession concluded in Judge Getzendanner's decision, which prevented the AMA from rebuilding barriers or developing another boycott. The chiropractic profession was ready to move into its next century.
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Johnson, Claire D., and Bart N. Green. "Looking back at the lawsuit that transformed the chiropractic profession part 2: Rise of the American Medical Association." Journal of Chiropractic Education 35, S1 (September 1, 2021): 25–44. http://dx.doi.org/10.7899/jce-21-23.
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Objective This paper is the second in a series that explores the historical events surrounding the Wilk v American Medical Association (AMA) lawsuit in which the plaintiffs argued that the AMA, the American Hospital Association, and other medical specialty societies violated anti-trust law by restraining chiropractors' business practices. The purpose of this paper is to provide a brief review of the history of how the AMA rose to dominate health care in the United States, and within this social context, how the chiropractic profession fought to survive in the first half of the 20th century. Methods This historical research study used a phenomenological approach to qualitative inquiry into the conflict between regular medicine and chiropractic and the events before, during, and after a legal dispute at the time of modernization of the chiropractic profession. Our methods included obtaining primary and secondary data sources. The final narrative recount was developed into 8 papers following a successive timeline. This paper is the second of the series that explores the growth of medicine and the chiropractic profession. Results The AMA's code of ethics established in 1847 continued to direct organized medicine's actions to exclude other health professions. During the early 1900s, the AMA established itself as “regular medicine.” They labeled other types of medicine and health care professions, such as chiropractic, as “irregulars” claiming that they were cultists and quacks. In addition to the rise in power of the AMA, a report written by Abraham Flexner helped to solidify the AMA's control over health care. Chiropractic as a profession was emerging and developing in practice, education, and science. The few resources available to chiropractors were used to defend their profession against attacks from organized medicine and to secure legislation to legalize the practice of chiropractic. After years of struggle, the last state in the US legalized chiropractic 79 years after the birth of the profession. Conclusion In the first part of the 20th century, the AMA was amassing power as chiropractic was just emerging as a profession. Events such as publication of Flexner's report and development of the medical basic science laws helped to entrench the AMA's monopoly on health care. The health care environment shaped how chiropractic grew as a profession. Chiropractic practice, education, and science were challenged by trying to develop outside of the medical establishment. These events added to the tensions between the professions that ultimately resulted in the Wilk v AMA lawsuit.
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Grace, Sandra, Roger Engel, and Ian Jalsion. "Themes Underlying Australian General Practitioner Views towards Chiropractic and Osteopathy: An Assessment of Free Text Data from a Cross-Sectional Survey." Evidence-Based Complementary and Alternative Medicine 2018 (2018): 1–7. http://dx.doi.org/10.1155/2018/2786106.
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The Australian chiropractic and osteopathic professions underwent a period of significant transformation between 1960 and 2000. This resulted in an improvement in the views held by the medical profession towards the two professions. However, a recent survey of Australian general practitioners (GPs) reported that a number of GPs still hold negative views towards chiropractors and osteopaths. This paper examines these views from the perspective of critical realism and explores the generative mechanisms that can influence the willingness of health practitioners to collaborate over patient care. A qualitative analysis of open-ended responses to a survey of 630 Australian GPs was conducted. Unfavourable attitudes of GPs towards chiropractors and osteopaths included perceived lack of safety, efficacy, and inadequacy of training, despite chiropractic’s and osteopathy’s reliance on the same evidence base and similar training to those of other manual therapy professions such as physiotherapy. These attitudes may be underpinned by the professional biases against chiropractic and osteopathy that continue to marginalise the professions within the Australian healthcare system. Continued investment in the research base for chiropractic and osteopathic practice is required, along with raising the awareness of GPs about the education and skills of chiropractors and osteopaths.
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Johnson, Claire D., and Bart N. Green. "Looking back at the lawsuit that transformed the chiropractic profession part 6: Preparing for the lawsuit." Journal of Chiropractic Education 35, S1 (September 1, 2021): 85–96. http://dx.doi.org/10.7899/jce-21-27.
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Objective This is the sixth article in a series that explores the historical events surrounding the Wilk v American Medical Association (AMA) lawsuit in which the plaintiffs argued that the AMA, the American Hospital Association, and other medical specialty societies violated antitrust law by restraining chiropractors' business practices. The purpose of this article is to provide a brief review of the plaintiffs, lead lawyer, and the events immediately before the lawsuit was filed. Methods This historical research study used a phenomenological approach to qualitative inquiry into the conflict between regular medicine and chiropractic and the events before, during, and after a legal dispute at the time of modernization of the chiropractic profession. Our methods included obtaining primary and secondary data sources. The final narrative recount was developed into 8 articles following a successive timeline. This article, the sixth of the series, explores the plaintiffs' stories. Results Because of the AMA's boycott on chiropractic, chiropractors were not able to collaborate with medical physicians or refer patients to medical facilities, which resulted in restricted trade and potential harm to patients' well-being. The plaintiffs, Patricia Arthur, James Bryden, Michael Pedigo, and Chester Wilk, came from different regions of the United States. Each had unique experiences and were compelled to seek justice. The lead lawyer, Mr George McAndrews, was the son of a chiropractor and had witnessed the effect that the AMA's attacks on chiropractic had on his father. It took several years to gather enough resources to file the suit, which was submitted in 1976. Conclusion The conflicts that the plaintiffs experienced stimulated them to pursue a lawsuit against the AMA and other organized political medicine groups.
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Johnson, Claire D., and Bart N. Green. "Looking back at the lawsuit that transformed the chiropractic profession part 3: Chiropractic growth." Journal of Chiropractic Education 35, S1 (September 1, 2021): 45–54. http://dx.doi.org/10.7899/jce-21-24.
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Objective This is the third paper in a series that explores the historical events surrounding the Wilk v American Medical Association (AMA) lawsuit in which the plaintiffs argued that the AMA, the American Hospital Association, and other medical specialty societies violated antitrust law by restraining chiropractors' business practices. The purpose of this paper is to provide a brief review of the history of the growth of chiropractic, its public relations campaigns, and infighting that contributed to the events surrounding the Wilk v AMA lawsuit. Methods This historical research study used a phenomenological approach to qualitative inquiry into the conflict between regular medicine and chiropractic and the events before, during, and after a legal dispute at the time of modernization of the chiropractic profession. Our methods included obtaining primary and secondary data sources. The final narrative recount was developed into 8 papers following a successive timeline. This paper is the third of the series that explores the growth the chiropractic profession. Results By the 1930s, the AMA was already under investigation for violation of antitrust laws and the National Chiropractic Association was suggesting that the AMA was establishing a health care monopoly. Chiropractic schools grew and the number of graduates rose quickly. Public relations campaigns and publications in the popular press attempted to educate the public about chiropractic. Factions within the profession polarized around differing views of how they thought that chiropractic should be practiced and portrayed to the public. The AMA leaders noted the infighting and used it to their advantage to subvert chiropractic. Conclusion Chiropractic grew rapidly and established its presence with the American public through public relations campaigns and popular press. However, infighting would give the AMA material to further its efforts to contain and eliminate the chiropractic profession.
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Johnson, Claire D., and Bart N. Green. "Looking back at the lawsuit that transformed the chiropractic profession part 5: Evidence exposed." Journal of Chiropractic Education 35, S1 (September 1, 2021): 74–84. http://dx.doi.org/10.7899/jce-21-26.
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Objective This is the fifth article in a series that explores the historical events surrounding the Wilk v American Medical Association (AMA) lawsuit in which the plaintiffs argued that the AMA, the American Hospital Association, and other medical specialty societies violated antitrust law by restraining chiropractors' business practices. The purpose of this article is to provide a brief review of events surrounding the eventual end of the AMA's Committee on Quackery and the exposure of evidence of the AMA's efforts to boycott the chiropractic profession. Methods This historical research study used a phenomenological approach to qualitative inquiry into the conflict between regular medicine and chiropractic and the events before, during, and after a legal dispute at the time of modernization of the chiropractic profession. Our methods included obtaining primary and secondary data sources. The final narrative recount was developed into 8 articles following a successive timeline. This article, the fifth of the series, explores the exposure of what the AMA had been doing, which provided evidence that was eventually used in the Wilk v AMA antitrust lawsuit. Results The prime mission of the AMA's Committee on Quackery was “first, the containment of chiropractic and, ultimately, the elimination of chiropractic.” However, the committee did not complete its mission and quietly disbanded in 1974. This was the same year that the chiropractic profession finally gained licensure in all 50 of the United States; received recognition from the US Commissioner of Education, Department of Health, Education and Welfare; and was successfully included in Medicare. In 1975, documents reportedly obtained by the Church of Scientology covert operatives under Operation AMA Doom revealed the extent to which the AMA and its Committee on Quackery had been working to contain and eliminate the chiropractic profession. The AMA actions included influencing mainstream media, decisions made by the Joint Commission on Accreditation of Hospitals, and the Department of Health, Education, and Welfare. Other actions included publishing propaganda against chiropractic and implementing an anti-chiropractic program aimed at medical students, medical societies, and the American public. Conclusion After more than a decade of overt and covert actions, the AMA chose to end its Committee on Quackery. The following year, documents exposed the extent of AMA's efforts to enact its boycott of chiropractic.
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Johnson, Claire D., and Bart N. Green. "Looking back at the lawsuit that transformed the chiropractic profession part 1: Origins of the conflict." Journal of Chiropractic Education 35, S1 (September 1, 2021): 9–24. http://dx.doi.org/10.7899/jce-21-22.
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Objective This paper is the first in a series that explores the historical events surrounding the Wilk v American Medical Association (AMA) lawsuit in which the plaintiffs argued that the AMA, the American Hospital Association, and other medical specialty societies violated antitrust law by restraining chiropractors' business practices. The purpose of this paper is to provide a brief review of the history of the AMA and the origins of chiropractic and to explore how the AMA began its monopoly of health care in the United States, possible reasons that organized medicine acted against chiropractic, and how these events influenced the chiropractic profession. Methods This historical research study used a phenomenological approach to qualitative inquiry into the conflict between regular medicine and chiropractic and the events before, during, and after a legal dispute at the time of modernization of the chiropractic profession. We used primary and secondary data sources. The final narrative recount was developed into 8 papers that follow a successive time line. This paper is the first of the series and explores the origins of the aversion of organized American medicine to other health professions and the origins of the chiropractic profession. Results The AMA began in the mid-1800s to unify like-minded “regular” medical physicians who developed a code of ethics and promoted higher educational standards. Their efforts to unify had excluded other types of health care providers, which they called “irregular” practitioners. However, Americans were seeking more natural alternatives to the harsh methods that regular medical physicians offered at that time. Nearly 50 years after the AMA began, the chiropractic profession attempted to emerge during a time when many patients valued vitalism and their freedom to choose what health care provider they would access. Conclusion During the years that chiropractic developed as a healing profession, organized medicine was already well established and developing a monopoly in American health care. These events created the foundation on which the tensions between these professions were built and ultimately resulted in the Wilk v AMA lawsuit.
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DiGregorio, Carl John. "QUESTIONING CHIROPRACTICS." Journal of the American Dental Association 145, no. 2 (February 2014): 127. http://dx.doi.org/10.1016/s0002-8177(14)60211-7.
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Sonenberg, Nahum, Stephen K. Burley, and Anne-Claude Gingras. "RNA chiropractics." Nature Structural Biology 5, no. 3 (March 1998): 172–74. http://dx.doi.org/10.1038/nsb0398-172.
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Chapman, Peter D., Amanda Meyer, Kenneth Young, Daniel Wibowo, and Bruce Walker. "Emphasis on various subtopics in the anatomy curriculum for chiropractic training: An international survey of chiropractors and anatomists." Journal of Chiropractic Education 29, no. 1 (March 1, 2015): 37–42. http://dx.doi.org/10.7899/jce-14-10.
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Objective The aim of this study was to conduct an international survey of the perceived optimal level of anatomy teaching from anatomy academics and practicing chiropractors. We hypothesized that the optimum level of anatomical understanding for chiropractic students does not differ between the anatomists teaching the students and practicing chiropractors. Methods The opinion of anatomists teaching in a chiropractic course (n = 16) was compared to practicing chiropractors (n = 589). The students' level of understanding was based on the revised Bloom's taxonomy for 16 different curriculum areas. Anatomists were recruited by contacting the accredited chiropractic courses worldwide. Snowball sampling was used for the practicing chiropractors. Independent-samples Mann-Whitney U tests were used to compare the results of anatomists and chiropractors. Results Opinions differed between anatomists and chiropractors on 9 out of the 16 questions. Where opinions differed, chiropractors recommended a higher standard of anatomical knowledge. The level suggested by chiropractors for these curriculum areas is equal to the “evaluating” level where chiropractic students can remember, understand, apply, and analyze anatomical knowledge to be able to justify a clinical decision. Conclusion Compared to anatomists working in chiropractic programs, chiropractors suggest a higher standard of anatomy be taught to undergraduates. Collaboration between chiropractors and anatomists would likely be beneficial in creating or modifying anatomy curricula for chiropractic students.
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PHILLIPS, REED B., IAN D. COULTER, ALAN ADAMS, AL TRAINA, and JOHN BECKMAN. "A CONTEMPORARY PHILOSOPHY OF CHIROPRACTIC FOR THE LOS ANGELES COLLEGE OF CHIROPRACTICS." Journal of Chiropractic Humanities 4 (1994): 20–25. http://dx.doi.org/10.1016/s1556-3499(13)60026-1.
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Wangler, Martin. "Usefulness of CanMEDS Competencies for Chiropractic Graduate Education in Europe." Journal of Chiropractic Education 23, no. 2 (October 1, 2009): 123–33. http://dx.doi.org/10.7899/1042-5055-23.2.123.
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Purpose: In 2008, the European Academy of Chiropractic decided to develop a competency-based model for graduate education in Europe. The CanMEDS (Canadian Medical Education Directives for Specialists) framework describes seven competency roles (fields) and key competencies identified as fundamental to all specialist doctors. It was not known how these fields are perceived by chiropractors in Europe. The purpose of this study was to compare perception scores of senior chiropractic as well as medical students with perception scores of licensed chiropractors and to analyze practitioners' remembered confidence in these competency fields. Methods: An anonymous 5-point Likert scale electronic questionnaire was sent to senior students of two chiropractic schools and licensed chiropractors of five European nations. Age and gender differences as well as differences in appraisal of the competencies in respect to importance and remembered confidence were analyzed. Results: Response rates were low to moderate. Agreement of importance of the seven competencies was not different between chiropractic and medical students as well as licensed chiropractors. Chiropractic students and chiropractors regarded all key competencies as important (averages ≥4.0). The importance versus remembered confidence was consistently judged higher by about 1/2 point on the 5-point scale, significant for all competency fields (p < .001). Conclusion: The seven competency fields seem to be of the same importance for chiropractic senior students and licensed chiropractors and might be considered as a base for future graduate training in chiropractic. The survey should be replicated with additional samples and further information should be gathered to reflect reality.
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Dodes, John E. "MORE ABOUT CHIROPRACTICS." Journal of the American Dental Association 145, no. 2 (February 2014): 127. http://dx.doi.org/10.1016/s0002-8177(14)60212-9.
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Adams, Jon, Wenbo Peng, Amie Steel, Romy Lauche, Craig Moore, Lyndon Amorin-Woods, and David Sibbritt. "A cross-sectional examination of the profile of chiropractors recruited to the Australian Chiropractic Research Network (ACORN): a sustainable resource for future chiropractic research." BMJ Open 7, no. 9 (September 2017): e015830. http://dx.doi.org/10.1136/bmjopen-2017-015830.
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ObjectivesThe Australian Chiropractic Research Network (ACORN) practice-based research network (PBRN) cohort was established to provide sustainable infrastructure necessary to address lack of rigorous investigation and to bridge the research–practice gap focused on chiropractic care for future years. This paper presents the profile of chiropractors recruited to the ACORN PBRN, a nationally representative sample of chiropractors working in Australia.DesignCross-sectional analysis of baseline data from a cohort study of chiropractors in Australia.SettingAll registered chiropractors in Australia were invited to participate in the ACORN study and those who completed a practitioner questionnaire and consent form were included in the PBRN cohort.ParticipantsA total of 1680 chiropractors (36%) were recruited to the cohort database. The average age of the PBRN participants is 41.9 years and 63% are male. The vast majority of the PBRN participants hold a university degree.ResultsGeneral practitioners were identified as the most popular referral source for chiropractic care and low back pain and neck pain were the most common conditions ‘often’ treated by the PBRN chiropractors. The chiropractors in this PBRN cohort rated high velocity, low amplitude adjustment/manipulation/mobilisation as the most commonly used technique/method and soft tissue therapy as the most frequently employed musculoskeletal intervention in their patient management.ConclusionsThe ACORN PBRN cohort constitutes the largest coverage of any single healthcare profession via a national voluntary PBRN providing a sustainable resource for future follow-up. The ACORN cohort provides opportunities for further nested substudies related to chiropractic care, chiropractors, their patients and a vast range of broader healthcare issues with a view to helping build a diverse but coordinated research programme and further research capacity building around Australian chiropractic.
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Melka, Hiwot A., Robb Russell, James Whedon, and Scott Haldeman. "Chiropractic Practice in the Continent of Africa: A Structured Online Survey of 608 Chiropractors." Journal of Manipulative and Physiological Therapeutics 44, no. 4 (May 2021): 280–88. http://dx.doi.org/10.1016/j.jmpt.2020.07.010.
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Foster, Ian E., and Jeffery Bagust. "Cutaneous Two-Point Discrimination Thresholds and Palpatory Sensibility in Chiropractic Students and Field Chiropractors." Journal of Manipulative and Physiological Therapeutics 27, no. 7 (September 2004): 466–71. http://dx.doi.org/10.1016/j.jmpt.2004.06.005.
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Foreman, Stephen M., and Michael J. Stahl. "Chiropractors Disciplined by a State Chiropractic Board and a Comparison with Disciplined Medical Physicians." Journal of Manipulative and Physiological Therapeutics 27, no. 7 (September 2004): 472–77. http://dx.doi.org/10.1016/j.jmpt.2004.06.006.
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Stuber, Kent. "The safety of chiropractic during pregnancy: A pilot e-mail survey of chiropractors’ opinions." Clinical Chiropractic 10, no. 1 (March 2007): 24–35. http://dx.doi.org/10.1016/j.clch.2006.10.003.
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Gorrell, Lindsay, Robyn L. Beirman, and Subramanyam R. Vemulpad. "Curriculum mapping within an Australian master of chiropractic program: Congruence between published evidence for chiropractic and student assessment tasks." Journal of Chiropractic Education 29, no. 1 (March 1, 2015): 29–36. http://dx.doi.org/10.7899/jce-14-9.
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Objective This study sought to determine congruence between student assessment tasks within the master of chiropractic curriculum at Macquarie University and 2 separate but related domains: (1) disorders commonly presenting to chiropractors and (2) musculoskeletal conditions for which there is published evidence that chiropractic treatment is effective. Methods A literature review was undertaken to determine which musculoskeletal disorders commonly present to chiropractors and the conditions for which there is published evidence that chiropractic treatment is effective. These 2 domains were then mapped to the assessment tasks within the curriculum and analyzed. The proportion of time allocated to theory versus skill acquisition was also determined. Results Assessment tasks within the curriculum specifically focus on low back pain, neck pain, lower extremity pain, thoracic pain, and adhesive capsulitis. This curriculum mapping demonstrates congruence between the student assessment tasks and published evidence for chiropractic. The assessments also contain an appropriate balance between theory and skills acquisition. Conclusion There is congruence between the assessment tasks within the curriculum and the 2 domains against which it was mapped. Thus, completion of the curriculum provides training relevant to conditions that commonly present to chiropractors and musculoskeletal conditions for which chiropractic treatment is effective.
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Gaumer, Gary, Annette Koren, and Eric Gemmen. "Barriers to expanding primary care roles for chiropractors: The role of chiropractic as primary care gatekeeper." Journal of Manipulative and Physiological Therapeutics 25, no. 7 (September 2002): 427–49. http://dx.doi.org/10.1067/mmt.2002.126474.
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Duenas, Richard. "Barriers to expanding primary care roles for chiropractors: the role of chiropractic as primary care gatekeeper." Journal of Manipulative and Physiological Therapeutics 27, no. 2 (February 2004): 137–39. http://dx.doi.org/10.1016/j.jmpt.2003.12.010.
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Gaumer, Dr Gary. "Barriers to expanding primary care roles for chiropractors: the role of chiropractic as primary care gatekeeper." Journal of Manipulative and Physiological Therapeutics 27, no. 2 (February 2004): 139. http://dx.doi.org/10.1016/j.jmpt.2003.12.011.
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Himelfarb, Igor, Bruce L. Shotts, and Andrew R. Gow. "Examining the validity of chiropractic grade point averages for predicting National Board of Chiropractic Examiners Part I exam scores." Journal of Chiropractic Education 36, no. 1 (December 29, 2021): 1–12. http://dx.doi.org/10.7899/jce-20-5.
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ABSTRACT Objective The main objective of this study was to evaluate the validity of grade point average (GPA) for predicting the National Board of Chiropractic Examiners (NBCE) Part I exam scores using chiropractic GPA. Methods Data were collected during the January 2019 computer-based testing administration of the NBCE's Part I exam. The sample size was n = 2278 of test takers from 18 domestic and 4 international chiropractic educational institutions. Six regression models were developed and tested to predict the Part I domain scores from chiropractic GPA while controlling for self-reported demographic variables. Residuals from the models were disaggregated by pre–chiropractic GPA. Results Chiropractic GPA revealed a positive, statistically significant correlation with sex. The chiropractic GPA was found to be a significant predictor of the Part I domain scores. A different perspective was obtained when residuals (observed minus predicted) were collected and split by the pre–chiropractic GPA. Very good students tended to be underpredicted, while other students were overpredicted. Conclusion This study builds on the cascading evidence from educational literature by providing additional results suggesting that undergraduate (prechiropractic) GPA as well as the GPA obtained in doctor of chiropractic programs are related to the future performance on the NBCE Part I exam. The results provide a first glance at the connection between the standardized test scores, which are often used for instructors' and institutional evaluation and the GPA obtained in a doctor of chiropractic program.
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Page, Stacey A., Jaroslaw P. Grod, and D. Gordon McMorland. "The Perspectives and Practices of Alberta Chiropractors Regarding the Sale of Health Care Products in Chiropractic Offices." Journal of Manipulative and Physiological Therapeutics 34, no. 7 (September 2011): 476–82. http://dx.doi.org/10.1016/j.jmpt.2011.05.013.
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De la Ruelle, Lobke P., Annemarie de Zoete, Cornelius Myburgh, Hella E. Brandt, and Sidney M. Rubinstein. "The perceived barriers and facilitators for chiropractic care in older adults with low back pain; insights from a qualitative exploration in a dutch context." PLOS ONE 18, no. 4 (April 12, 2023): e0283661. http://dx.doi.org/10.1371/journal.pone.0283661.
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Background Understanding care seeking behaviour is vital to enabling access to care. In the context of low back pain (LBP), chiropractors offer services to patients of all ages. Currently, geriatric sub-populations tend to be under-investigated, despite the disproportionate effects of LBP on older adults. In the Netherlands, the chiropractic profession is relatively unknown and therefore, generally speaking, is not considered as the first choice for conservative musculoskeletal primary health care. The aim of this paper was to explore the experiences of older adults with LBP, seeking chiropracic care for the first time, in order to identify perceived barriers and facilitators in this process. Methods Stage 1: Participants 56 years of age and older with chronic LBP who either sought or did not seek chiropractic care were interviewed to provide detailed information on the factors that promoted or impeded care-seeking behaviour. A purposive sampling strategy was used to recruit participants through a network of researchers, chiropractors and other healthcare professionals offering musculoskeletal health care services. Individuals with underlying pathology, previous surgery for LBP, or insufficient mastery of the Dutch language were excluded. Data were collected until saturation was reached and thematically analysed. Stage 2: To further explore the themes, a focus group interview was conducted with a provider stakeholder group consisting of:two physiotherapists, a nurse practitioner, a geriatrician, and a chiropractor. All interviews were conducted online, voice recorded, and transcribed verbatim. Results We interviewed 11 older adults with low back pain. During this process four themes emerged that captured their perception and experiences in either seeking or dismissing chiropractic care for their LBP; these being ‘generic’, ‘financial’, ‘expectation’, and ‘the image of the chiropractor’. The focus group members largely confirmed the identified themes, highlighting a lack of awarenes and accessibility as key barriers to care. On the other hand, whe chiropractior as an alternative care provider, with a focus on manual interventions, was seen as a facilitator. Conclusions The lack of knowledge about chiropractic care was found to be the most important barrier to seeking care. The most important facilitator was insufficient resolution of their symptoms following previous care, making patients look further for a solution for their problem. These barriers and facilitators seem not to differ greatly from barriers and facilitators found among younger patients with neck pain. Age and health condition may therefore be weak determinants of care. This new information may help us optimize accessibility for older adults to the chiropractor.
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Sigrell, Håkan. "Supervision of chiropractors: A summary of results from two surveys involving chiropractic supervisors and graduates in England and Sweden." Journal of Manipulative and Physiological Therapeutics 22, no. 4 (May 1999): 209–15. http://dx.doi.org/10.1016/s0161-4754(99)70046-1.
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Johnson, Claire D., and Bart N. Green. "Looking back at the lawsuit that transformed the chiropractic profession: Authors' introduction." Journal of Chiropractic Education 35, S1 (September 1, 2021): 5–8. http://dx.doi.org/10.7899/jce-21-21.
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This paper provides the authors' introduction to Looking Back: A Historical Review of the Lawsuit That Transformed the Chiropractic Profession, which is a series of papers that reviews events surrounding the federal antitrust lawsuit Wilk v American Medical Association. Information in this series describes the events before, during, and after the lawsuit and the relevant issues related to the transformation of American mainstream health care and chiropractic. These papers give insight into many of the factors that shaped the chiropractic profession that we know today.
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Pringle, R. Kevin. "Sports chiropractic." Journal of Manipulative and Physiological Therapeutics 23, no. 6 (August 2000): 0439–40. http://dx.doi.org/10.1067/mmt.2000.108137a.
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Young, Antoinette. "Chiropractic pediatrics." British Journal of Chiropractic 5, no. 1-2 (January 2001): 34. http://dx.doi.org/10.1016/s1466-2108(01)80013-9.
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Moore, Keri M., Deisy Amorin-Woods, Lyndon G. Amorin-Woods, Dein Vindigni, and Navine G. Haworth. "A cross-sectional study of Australian chiropractors' and students' readiness to identify and support patients experiencing intimate partner violence." Journal of Chiropractic Education, February 13, 2023. http://dx.doi.org/10.7899/jce-21-45.
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ABSTRACT Objective To explore Australian chiropractors' and final year students' readiness to identify and support patient's experiencing intimate partner violence (IPV). Methods This cross-sectional study used the Chiro-PREMIS, an adaptation of the Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) to explore chiropractors' and final year students' readiness. Survey responses were analyzed through a lens of Miller's framework for developing clinical competence and chiropractic graduate competencies. Results One hundred forty participants completed the online survey (n = 99 chiropractors and n = 41 students). Reports of practice over the 4 weeks prior to completing the survey showed 21% of chiropractors and 20% of students consulted with patients who had disclosed they were involved in IPV. Thirty-three percent of chiropractors and 27% of students suspected a patient was involved, but that patient did not disclose. Participants report meager training in IPV. Many are unclear about appropriate questioning techniques, documentation, referrals, identifying available resources, and legal literacy. Overall, participants do not “know” about IPV, they do not “know how” to and may not be able to “show how” or “do” when it comes to managing IPV-related clinical scenarios. Further studies are needed to confirm if chiropractors have the appropriate clinical capabilities. Conclusion With proper preparation, chiropractors have an opportunity to make a positive contribution to this social problem. We anticipate chiropractic-specific discourse surrounding these escalating growing social concerns will highlight the intent of the chiropractic profession to make a substantial contribution to the health care of the Australian public. More studies are needed.
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Dubuc, Élisa, Isabelle Pagé, Pierre B. Boucher, Danica Brousseau, Sébastien Robidoux, and Marc-André Blanchette. "Chiropractic techniques and treatment modalities included in academic programs: A survey of chiropractic educational institutions." Journal of Chiropractic Education, April 28, 2022. http://dx.doi.org/10.7899/jce-21-32.
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ABSTRACT Objective The chiropractic techniques that chiropractors learn during their training strongly influence the nature of treatments provided by chiropractors and their professional identity. The objective of this project is to provide an exhaustive description of all chiropractic techniques and treatment modalities taught in chiropractic educational institutions. Methods International experts were solicited to provide feedback on the exhaustivity and clarity of our preliminary questionnaire. Following the expert suggestions, we administered our cross-sectional survey representatives of all chiropractic education institutions listed on the World Federation of Chiropractic website. We also asked the contact information for an additional contact from each institution and surveyed them for triangulation purposes. Results Among the 47 chiropractic education institutions surveyed, 29 completed our survey (response rate: 62%) of which 18 (62%) had 2 respondents. Among all the chiropractic techniques and treatment modalities investigated, only the Diversified technique was included in the core curriculum of all responding institutions. A considerable proportion of the techniques or modalities studied were not included in the educational activities of the institutions, particularly within the manual tonal or reflex techniques, instrument-assisted articular techniques, as well as the other techniques or modalities categories. Surprisingly, exercise prescription was not included in the core curriculum of all the institutions. Some scientifically challenged approaches were included in the educational activities of more than 40% of the institutions. Conclusion The portfolio of therapeutic teaching varies greatly between chiropractic educational institutions. A more standardized therapeutic curriculum could be beneficial to reduce public and interprofessional confusion toward therapeutic approaches in chiropractic.
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BSc, Rosemary Giuriato, Goran Štrkalj, Tania Prvan, and Nalini Pather. "Musculoskeletal anatomy core syllabus for Australian chiropractic programs: A pilot study." Journal of Chiropractic Education, May 13, 2022. http://dx.doi.org/10.7899/jce-21-18.
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ABSTRACT Objective The aim of this study is to conduct a pilot survey to determine core anatomy content for chiropractic curriculum based on the perception of chiropractors and anatomy educators involved in teaching in an Australian chiropractic program. Methods A survey of anatomical structures previously used in a medical survey, with similar criteria for synthesizing responses, was used and classified according to whether the respondents rated an item as essential, important, acceptable, or not required in a chiropractic program. The item was scored as core if ≥60% of respondents rated it essential, recommended if 30%–59% rated it essential, not recommended if 20%–29% rated it essential, or not core if <20% rated it essential. Results The respondents rated 81.6% of all musculoskeletal concepts as core and 18.4% as recommended, 88.8% of the vertebral column items as core, and 11.2% of the items as recommended, 69.4% upper limb and pectoral girdle items as core, 23.7% of items as recommended, 5.5% as not recommended and 1.3% as not core items for inclusion, 85.3% of all lower limb and pelvic girdle items as core, 14.4% as recommended and 0.3% not recommended. Conclusion Chiropractors and anatomists involved in teaching in an Australian chiropractic program rated most musculoskeletal items as essential for inclusion in a chiropractic teaching program to ensure adequate preparation for safe practice and to promote alignment with the standards of anatomy education delivered into the clinical professions.
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Hayes, Rebecca, Camille Imbeau, Katherine A. Pohlman, Marc-André Blanchette, and Chantale Doucet. "Chiropractic care and research priorities for the pediatric population: a cross-sectional survey of Quebec chiropractors." Chiropractic & Manual Therapies 31, no. 1 (September 26, 2023). http://dx.doi.org/10.1186/s12998-023-00514-z.
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Abstract Background Chiropractors commonly treat pediatric patients within their private practices. The objectives of this study were (1) to identify the treatment techniques and health advice used by Quebec chiropractors with pediatric patients; (2) to explore the research priorities of Quebec chiropractors for the pediatric population; and (3) to identify Quebec chiropractors’ training in the field of pediatric chiropractics. Methods A web-based cross-sectional survey was conducted among all licensed Quebec chiropractors (Qc, Canada). Descriptive statistics were used to analyze all quantitative variables. Results The results showed that among the 245 respondents (22.8% response rate), practitioners adapted their treatment techniques based on their patients’ age group, thus using softer techniques with younger pediatric patients and slowly gravitating toward techniques used with adults when patients reached the age of six. In terms of continuing education, chiropractors reported an average of 7.87 h of training on the subject per year, which mostly came from either Quebec’s College of Chiropractors (OCQ) (54.7%), written articles (46.9%) or seminars and conferences (43.7%). Both musculoskeletal (MSK) and viscerosomatic conditions were identified as high research priorities by the clinicians. Conclusions Quebec chiropractors adapt their treatment techniques to pediatric patients. In light of limited sources of continuing education in the field of pediatric chiropractics, practitioners mostly rely on the training provided by their provincial college and scientific publications. According to practitioners, future research priorities for pediatric care should focus on both MSK conditions and non-MSK conditions.
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Leach, Matthew J., Per J. Palmgren, Oliver P. Thomson, Gary Fryer, Andreas Eklund, Stina Lilje, Jon Adams, Eva Skillgate, and Tobias Sundberg. "Skills, attitudes and uptake of evidence-based practice: a cross-sectional study of chiropractors in the Swedish Chiropractic Association." Chiropractic & Manual Therapies 29, no. 1 (January 11, 2021). http://dx.doi.org/10.1186/s12998-020-00359-w.
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Abstract Background Evidence-based practice (EBP) is integral to the delivery of high-quality health care. Chiropractic has been a licensed health profession in Sweden since 1989, but little is known of the uptake of EBP in this professional group. This study explored the self-reported skills, attitudes and uptake of EBP, and the enablers and barriers of EBP uptake, among licensed chiropractors in Sweden. Methods Licensed chiropractors (n = 172) of the Swedish Chiropractic Association (Legitimerade Kiropraktorers Riksorganisation) were invited to participate in an anonymous online questionnaire, using the Evidence-Based Practice Attitude and Utilisation Survey (EBASE) in February 2019. Results Fifty-six (33%) chiropractors completed the survey. Participants were predominantly male, aged 30–49 years, held a Master’s degree, and had received their highest qualification and practiced chiropractic for over a decade. Chiropractors rated their EBP skill-level mostly in the moderate to moderate-high range. The majority of chiropractors reported positive attitudes towards EBP, with most agreeing or strongly agreeing that EBP is necessary in the practice of chiropractic, and that EBP assists in making decisions about patient care. Chiropractors reported an average level of engagement in EBP activities. All participants indicated professional literature and research findings were useful in their day-to-day chiropractic practice. The main perceived enabler of EBP uptake was internet access in the workplace, whereas the main barrier to EBP uptake was lack of clinical evidence in chiropractic. Conclusions Participating chiropractors of the Swedish Chiropractic Association were generally favourable of EBP, though only reported modest levels of EBP-related skills and engagement in EBP activities. Our findings suggest future studies investigating interventions focussed on improving chiropractors’ skills and uptake of EBP are warranted.
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Leach, Matthew J., Per J. Palmgren, Oliver P. Thomson, Gary Fryer, Andreas Eklund, Stina Lilje, Jon Adams, Eva Skillgate, and Tobias Sundberg. "Skills, attitudes and uptake of evidence-based practice: a cross-sectional study of chiropractors in the Swedish Chiropractic Association." Chiropractic & Manual Therapies 29, no. 1 (January 11, 2021). http://dx.doi.org/10.1186/s12998-020-00359-w.
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Abstract Background Evidence-based practice (EBP) is integral to the delivery of high-quality health care. Chiropractic has been a licensed health profession in Sweden since 1989, but little is known of the uptake of EBP in this professional group. This study explored the self-reported skills, attitudes and uptake of EBP, and the enablers and barriers of EBP uptake, among licensed chiropractors in Sweden. Methods Licensed chiropractors (n = 172) of the Swedish Chiropractic Association (Legitimerade Kiropraktorers Riksorganisation) were invited to participate in an anonymous online questionnaire, using the Evidence-Based Practice Attitude and Utilisation Survey (EBASE) in February 2019. Results Fifty-six (33%) chiropractors completed the survey. Participants were predominantly male, aged 30–49 years, held a Master’s degree, and had received their highest qualification and practiced chiropractic for over a decade. Chiropractors rated their EBP skill-level mostly in the moderate to moderate-high range. The majority of chiropractors reported positive attitudes towards EBP, with most agreeing or strongly agreeing that EBP is necessary in the practice of chiropractic, and that EBP assists in making decisions about patient care. Chiropractors reported an average level of engagement in EBP activities. All participants indicated professional literature and research findings were useful in their day-to-day chiropractic practice. The main perceived enabler of EBP uptake was internet access in the workplace, whereas the main barrier to EBP uptake was lack of clinical evidence in chiropractic. Conclusions Participating chiropractors of the Swedish Chiropractic Association were generally favourable of EBP, though only reported modest levels of EBP-related skills and engagement in EBP activities. Our findings suggest future studies investigating interventions focussed on improving chiropractors’ skills and uptake of EBP are warranted.
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Schut, Samuel M. "Postgraduate training opportunities for chiropractors: A description of United States programs." Journal of Chiropractic Education, January 23, 2024. http://dx.doi.org/10.7899/jce-23-23.
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ABSTRACT Objective The objective of this study was to describe and compare the current postgraduate training opportunities (PTOs) in the United States (US) for which doctors of chiropractic are eligible, namely, residencies, fellowships, and board certifications. Methods An internet search of publicly available English-language websites on Google.com was executed using a cache-cleared private browser and key search phrases. Following webpage data extraction, e-mail and telephone follow-up were completed with officials from institutions offering doctor of chiropractic programs possessing accreditation by the Council on Chiropractic Education (CCE) in the US. Additional programs identified were annotated and incorporated into the data set if they met the inclusion criteria. Descriptive statistics were generated following data aggregation. Results Three-hundred internet search results were screened, 70 of which were assessed for eligibility and 47 included for descriptive analysis. Among the 16 CCE-accredited institutions solicited, 13 returned correspondence (81.3% response rate), resulting in the addition of 2 programs to the data set ascertained by the initial web search. There were 49 PTOs for chiropractors. Of programs available, residencies represented 49.0% (24/49) of programs, and fellowships represented 12.2% (6/49) of programs. There were 19 board specialty diplomate programs, constituting 38.8% of PTOs. Conclusion This work details preliminary descriptive information on the current state of US-based PTOs for chiropractors.
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Cupler, Zachary A., Morgan Price, and Clinton J. Daniels. "The prevalence of suicide prevention training and suicide-related terminology in United States chiropractic training and licensing requirements." Journal of Chiropractic Education, January 21, 2022. http://dx.doi.org/10.7899/jce-21-14.
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ABSTRACT Objective To summarize the prevalence of suicide-related terminology in US doctor of chiropractic educational programs, residency programs, continuing education training, diplomate training programs, and state licensure requirements. The secondary objective was to provide next-step recommendations to enhance suicide prevention education and training for the profession. Methods A review of public-facing electronic documents and websites occurred from April to May 2020 for doctor of chiropractic program course catalogs, residency program curriculum overviews, state licensing requirements, candidate handbooks for the chiropractic specialties, and continuing education training. Data were extracted to tables reflecting the state of suicide prevention training and suicide-related terminology. Descriptive statistics were used to report the findings. Results Of 19 doctor of chiropractic programs, 54 relevant courses were identified. No course catalogs specifically mentioned suicide prevention education, but specific risk factor-related terminology was highlighted. For the 10 doctor of chiropractic residency programs, all required mandatory trainee training, which included suicide prevention education. Two states required suicide prevention education training as part of the state re-licensure process and are available through 4 continuing education courses. No diplomate training program handbooks included a requirement of suicide prevention education though suicide risk-factor terminology was described in some handbooks. Conclusion The state of suicide prevention training in the chiropractic profession documented in handbooks is largely lacking and widely varied at this time. The development of profession-specific suicide prevention continuing education may be beneficial for practicing chiropractors, and suicide prevention curriculum development at the doctor of chiropractic programs may prepare future doctors of chiropractic.
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Emary, Peter C., Mark Oremus, Taco A. W. Houweling, Martin Wangler, and Noori Akhtar-Danesh. "Attitudes, beliefs, and practices among Swiss chiropractors regarding medication prescribing for musculoskeletal conditions: a national Q-methodology study." Chiropractic & Manual Therapies 28, no. 1 (October 20, 2020). http://dx.doi.org/10.1186/s12998-020-00341-6.
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Abstract Background Swiss chiropractors have been licensed since 1995 to prescribe from a limited formulary of medications for treating musculoskeletal (MSK) conditions. In January 2018, this formulary was expanded to include additional muscle relaxant, analgesic, and anti-inflammatory medications. Internationally, controversy remains over whether or not medication prescribing should be pursued within the chiropractic profession. Objective The purpose of this study was to assess Swiss chiropractors’ attitudes, beliefs, and practices regarding their existing medication prescription privileges. This information will provide new insights on the topic and help inform research and policy discussions about expanding chiropractic prescription rights in other jurisdictions. Methods A 13-item questionnaire and Q-methodology approach were used to conduct the assessment. Recruitment was conducted by e-mail between December 2019 and February 2020, and all members of the Swiss Chiropractic Association were eligible to participate. Data were analyzed using by-person factor analysis and descriptive statistics. Results In total, 187 Swiss chiropractors participated in this study (65.4% response rate). Respondents reported prescribing analgesics, anti-inflammatories, and muscle relaxants to a median of 5, 5, and 0% of patients, respectively. Forty-two percent of respondents expressed interest in further expanding the range of current medications available to Swiss chiropractors for treating MSK conditions. Only 15% expressed interest in expanding this range to include medications for treating non-MSK conditions. In the Q-methodology analysis, four salient viewpoints/groups regarding medication prescribing emerged: prescribers, non-prescribers, collaborators, and integrators. All except non-prescribers thought medication prescription privileges were advantageous for the chiropractic profession in Switzerland. There was also strong consensus among all four groups that medication prescribing should not replace manual therapy in chiropractic practice. Conclusion This was the first national survey on attitudes toward prescribing medications among Swiss chiropractors since the year 2000, and the first using Q-methodology. With this approach, four unique groups of chiropractic prescribers were identified. Even with diversity among clinicians, the findings of this study showed general support for, along with conservative use of, prescribing privileges within the Swiss chiropractic profession. Studies in jurisdictions outside of Switzerland are needed to assess whether chiropractors are interested in expanding their scopes of practice to include similar prescribing privileges.
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Myburgh, Corrie, Julie Andersen, Nicklas Bakkely, Jakob Hermannsen, Marcus Zuschlag, Philip Damgaard, and Eleanor Boyle. "The Danish sports chiropractic landscape: an exploration of practice characteristics and salient developmental issues." Chiropractic & Manual Therapies 29, no. 1 (June 29, 2021). http://dx.doi.org/10.1186/s12998-021-00383-4.
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Abstract Background As is the case around the globe, the Danish chiropractic community appears to be an active service provider for the athletic sub-population. However, a paucity of evidence elucidating the experiences, perceptions, and practices of individuals who identify as ‘sports chiropractors’ complicates strategic development efforts. Methods A sequential mixed-methods study was conceptualized in which interview responses from seven purposefully selected stakeholders provided context and informed a national descriptive survey exploring practice characteristics and opinions regarding sports chiropractic among Danish chiropractors. Results Thematic highlights included divided opinions on the criteria that define a sports chiropractor, the role of a chiropractor functioning beyond the clinic setting, and the need for a structured approach to developing sports chiropractic as a legitimate sub-specialty. The survey response rate was 34.9% (227 of 651), with 27% of responders identifying as a ‘sports chiropractor’. Compared to non-sports chiropractors, sports chiropractors engaged in a significantly higher level of interprofessional practice (3.8 versus 2.7 partners), in particular medical doctors (p = 0.016) and personal trainers (p < 0.001). Whether participants identified as a sports chiropractor or not, there was consensus that a high-quality post-graduate qualification and continued education was important. Generally speaking, the framing of sports chiropractic into a protected title was not a priority. Conclusion The Danish sports chiropractor tends to be male, has a specialist education and engages other chiropractors, medical practitioners and professional trainers more often as practice partners than generalist chiropractors. The position of the sports chiropractor as a ‘knowledgeable expert’ was seen as more important than establishing a protected title. Experiential training appears to be an untapped resource for developing real-world competency and gaining greater professional exposure. Given the potential for development across Europe, more focus is required on a strategic plan for embedding chiropractic professionals in inter-professional athletic health and performance practice settings.
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Vindigni, Dein, Laura Zark, Tobias Sundberg, Matthew Leach, Jon Adams, and Michael F. Azari. "Chiropractic treatment of older adults with neck pain with or without headache or dizziness: analysis of 288 Australian chiropractors’ self-reported views." Chiropractic & Manual Therapies 27, no. 1 (December 2019). http://dx.doi.org/10.1186/s12998-019-0288-1.
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Abstract Background Neck pain is a leading cause of individual and societal burden worldwide, affecting an estimated 1 in 5 people aged 70 years and older. The nature and outcomes of chiropractic care for older adults with neck pain, particularly those with co-morbid headaches, remains poorly understood. Therefore, we sought to ascertain: What proportion of Australian chiropractors’ caseload comprises older adults with neck pain (with or without headache); How are these conditions treated; What are the reported outcomes? Methods An online survey examining practitioner and practice characteristics, clinical patient presentations, chiropractic treatment methods and outcomes, and other health service use, was distributed to a random nationally representative sample of 800 Australian chiropractors. Quantitative methods were used to analyze the data. Results Two hundred eighty-eight chiropractors (response rate = 36%) completed the survey between August and November 2017. Approximately one-third (M 28.5%, SD 14.2) of the chiropractors’ patients were older adults (i.e. aged ≥65 years), of which 45.5% (SD 20.6) presented with neck pain and 31.3% (SD 20.3) had co-morbid headache. Chiropractors reported to combine a range of physical and manual therapy treatments, exercises and self-management practices in their care of these patients particularly: manipulation of the thoracic spine (82.0%); activator adjustment of the neck (77.3%); and massage of the neck (76.5%). The average number of visits required to resolve headache symptoms was reported to be highest among those with migraine (M 11.2, SD 8.8). The majority of chiropractors (57.3%) reported a moderate response to treatment in reported dizziness amongst older adults with neck pain. Approximately 82% of older adult patients were estimated to use at least one other health service concurrently to chiropractic care to manage their neck pain. Conclusion This is the first known study to investigate chiropractic care of older adults living with neck pain. Chiropractors report using well-established conservative techniques to manage neck pain in older adults. Our findings also indicate that this target group of patients may frequently integrate chiropractic care with other health services in order to manage their neck pain. Further research should provide in-depth investigation of older patients’ experience and other patient-reported outcomes of chiropractic treatment.
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Shannon, Nicholas, and Jon Patricios. "Sports-related concussion: assessing the comprehension, collaboration, and contribution of chiropractors." Chiropractic & Manual Therapies 30, no. 1 (December 27, 2022). http://dx.doi.org/10.1186/s12998-022-00471-z.
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AbstractOver the last 2 decades, sports-related concussion (SRC) awareness and management have evolved from an emphasis on complete cognitive and physical rest to evidence-based protocols and interventions. Chiropractors are primary care providers with exposure to athletes and teams in collision sports and, in addition, manage patients with concussion-like symptoms including neck pain, dizziness, and headache. With SRC frequently occurring in the absence of a medical practitioner, the role of allied health practitioners like chiropractors should be emphasised when it comes to the recognition, assessment, and management of SRC. This commentary discusses the potential contribution of chiropractors in SRC and the specific role their expertise in the cervical spine may play in symptom evaluation and management. A PubMed and Google scholar review of the chiropractic SRC literature suggests that the chiropractic profession appears under-represented in concussion research in athletic populations compared to other medical and allied health fields. This includes an absence of chiropractic clinicians with a focus on SRC participating in the Concussion in Sport Group (CISG) and the International Consensus Conferences on Concussion. Furthermore, with evolving evidence suggesting the importance of cervicogenic manifestations in SRC, there is an opportunity for chiropractors to participate in SRC diagnosis and management more fully and contribute scientifically to an area of specialised knowledge and training. With a dearth of chiropractic orientated SRC science, clinical SRC expertise, and clinical chiropractic representation in the CISG; it is incumbent on chiropractic clinicians and scientists to take up this opportunity through meaningful contribution and involvement in the SRC field.
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Emary, Peter Charles, and Kent Jason Stuber. "Chiropractors' attitudes toward drug prescription rights: a narrative review." Chiropractic & Manual Therapies 22, no. 1 (September 24, 2014). http://dx.doi.org/10.1186/s12998-014-0034-7.
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Abstract Background The right to prescribe drugs remains a contentious issue within the chiropractic profession. Nevertheless, drug prescription by manual therapy providers is currently an important topic. Notably, physiotherapists in the United Kingdom were recently granted limited independent prescribing rights. Reports suggest that physiotherapists in Australia now want those same rights, and as such a review of chiropractors' general attitudes toward drug prescription is needed. Objective To examine the literature concerning chiropractors' attitudes toward drug prescription rights and to compare the opinions of chiropractors currently licensed to prescribe medication with those in the profession who are not. Methods This was a narrative review, consisting of a formal literature search and summary of included articles. Electronic databases searched included the Cumulative Index to Nursing and Allied Health Literature, PubMed, and the Index to Chiropractic Literature. Inclusion criteria consisted of prospective studies published in English in peer-reviewed journals. Studies were required to contain data on chiropractors' opinions toward medication prescription rights. Results Of 33 articles identified, a total of seven surveys were included in the review. Of these, there was a general split in opinion among chiropractors regarding the right to prescribe drugs in chiropractic practice. Those supportive of prescribing rights favoured a limited number of over-the-counter and/or prescription-based medications such as analgesics, anti-inflammatories, and muscle relaxants. When questioned on full prescribing rights, however, chiropractors were generally opposed. In jurisdictions where chiropractors are currently licensed to prescribe from a limited formulary, such as in Switzerland, the majority perceived this right as an advantage for the profession. Moreover, continuing education in pharmacology was viewed as a necessary component of this privilege. Conclusions Based on the literature to date there is a general split in chiropractors' attitudes toward drug prescription rights. This split is most pronounced in countries where chiropractors are not licensed to prescribe medications. Notwithstanding, this is an important topic in chiropractic currently and warrants both further discussion and research to determine future directions and the implications of either pursuit or denial of prescription rights by chiropractors. Future surveys and/or qualitative studies of other chiropractors' opinions toward gaining prescription privileges would be timely.
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Gliedt, Jordan A., Maureen Reynolds, Steffany Moonaz, Cynthia R. Long, Robb Russell, and Michael J. Schneider. "Identifying and addressing patient substance use: a survey of chiropractic clinicians." Chiropractic & Manual Therapies 31, no. 1 (July 3, 2023). http://dx.doi.org/10.1186/s12998-023-00490-4.
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Abstract Background Chiropractors commonly encounter patients who present for spine pain with parallel substance use. There is currently no widespread training within the chiropractic profession to prepare chiropractors to recognize and address substance use in clinical practice. The purpose of this study was to examine chiropractors’ confidence, self-perceptions, and interest in education associated with identifying and addressing patient substance use. Methods A 10-item survey was developed by the authors. The survey addressed chiropractors’ assessment of their training, experiences, and educational interest/needs regarding identifying and addressing patient substance use. The survey instrument was uploaded to Qualtrics and was electronically distributed to chiropractic clinicians at active and accredited English-speaking Doctor of Chiropractic degree programs (DCPs) in the United States. Results A total of 175 individual survey responses were returned from a total of 276 eligible participants (63.4% response rate) from 16 out of 18 active and accredited English-speaking DCPs (88.8% of DCPs) in the United States. Nearly half of respondents strongly disagreed or disagreed (n = 77, 44.0%) that they were confident in their ability to identify patients who misuse prescription medication. The majority of respondents (n = 122, 69.7%) indicated that they did not have an established referral relationship with local clinical providers who provide treatment for individuals who use drugs or misuse alcohol or prescription medications. Most respondents strongly agreed or agreed (n = 157, 89.7%) that they would benefit from participating in a continuing education course on topics related to patients who use drugs or misuse alcohol or prescription medications. Conclusions Chiropractors indicated a need for training to help them identify and address patient substance use. There is a demand among chiropractors to develop clinical care pathways for chiropractic referrals and collaboration with health care professionals who provide treatment for individuals who use drugs or misuse alcohol or prescription medications.
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Clohesy, Natalie, Anthony Schneiders, Gaery Barbery, and Steven Obst. "Clinicians’ perceived value and demographic factors that predict the utilisation of patient reported outcome measures for low back pain amongst chiropractors in Australia." Chiropractic & Manual Therapies 29, no. 1 (November 1, 2021). http://dx.doi.org/10.1186/s12998-021-00399-w.
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Abstract Background Factors that influence utilisation rates of patient reported outcome measures (PROMs) for low back pain (LBP) within the chiropractic profession of Australia are currently unknown. This study aimed to examine whether factors, including age, sex, experience level, clinical title (principal vs associate), or a clinicians’ perceived value of PROMs, are predictive of the frequency and/or type of PROMs used by chiropractors in the management of LBP. Methods A cross sectional online survey was distributed to members of the Chiropractic Association of Australia (CAA now known as Australian Chiropractors Association-ACA) and Chiropractic Australia (CA). 3,014 CAA members and 930 CA members were invited to participate totaling 3,944, only respondents that were using PROMs were included in the analysis (n = 370). Ordinal logistic regression was used to examine associations between clinician demographics and perceived value of PROMs, and the frequency of pain, health, and functional patient reported outcome measure (PROM) usage by chiropractors. Results Principal chiropractors were more likely (Wald = 4.101, p = 0.04, OR = 1.4 (1.0–2.1)) than associate chiropractors to frequently use pain-related PROMs for the management of patients with LBP. The remaining demographic factors (age, sex, and experience level) were not associated with the frequency of PROM usage; nor were the perceived value clinicians place on PROMs in clinical practice. Conclusion Principal chiropractors were more likely to frequently use pain-related PROMs for the management of patients with LBP when compared to associate chiropractors. Demographic factors, appear to have little influence on PROM usage. While chiropractors place high value on PROMs, these beliefs are not associated with increased frequency of PROM usage for the management of LBP.
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Odierna, Donna H., Farida Savai, Lori L. Pino, J. David Currie, and Monica Smith. "“It's the most important work we will ever do”: Chiropractic students' service-learning experiences at a day laborer center in California." Journal of Chiropractic Education, September 25, 2023. http://dx.doi.org/10.7899/jce-22-19.
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ABSTRACT Objective From 2009 to 2019, staff, students, and faculty volunteers from a chiropractic college started Mission Trip America, later re-named Service Trip America (STA), providing monthly free chiropractic services at a hiring hall for day laborers in San Francisco until the 2020 COVID-19 hiatus. We report on volunteers' service-learning experiences. Methods Mixed-methods analysis comprising document review, descriptive report of site visit records, and thematic analysis of semi-structured interviews with 12 student and faculty volunteers. Results STA conducted 104 visits (8–11 per year) including 2272 patient encounters. Document review revealed an average of 22 patients per visit, with 60% to 85% return patients. On average, 3 student interns and 2 student assistants attended each visit, supervised by a doctor of chiropractic faculty member and the program director. Most commonly, interns treated 8 patients during the 4- to 5-hour visits. Patient concerns included musculoskeletal problems and other health conditions commonly seen at chiropractic offices and teaching clinics. Interns also regularly saw chronic health problems exacerbated by poor living conditions, violence, limited access to health care, low educational attainment, chronic stress, and the extreme biomechanical loading resulting from heavy labor. Interview results yielded 4 themes: learning, attitudes, challenges, and program strengths. Interviewees described opportunities to learn while working with a marginalized population and discussed long-term effects on their postgraduation practice as chiropractors. Conclusion Patients' physical, mental health, and psychosocial issues illustrated unique circumstances and profound needs of the underserved population being cared for by STA volunteers. Our findings may provide guidance for other community-based chiropractic service-learning programs in marginalized and underserved communities.
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O’Neill, Søren Francis Dyhrberg, Casper Nim, Dave Newell, and Charlotte Leboeuf-Yde. "A new role for spinal manual therapy and for chiropractic? Part I: weaknesses and threats." Chiropractic & Manual Therapies 32, no. 1 (March 26, 2024). http://dx.doi.org/10.1186/s12998-024-00531-6.
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AbstractSpinal manual therapy is central to chiropractic history, clinical practice, and professional identity. That chiropractors have developed an expertise in this domain has provided some considerable advantages. However, we contend it is also at the crux of the ideological schism that fractures the chiropractic profession. In this article, which is the first in a series of two, we discuss chiropractors’ understanding and use of spinal manual therapy and do so with particular emphasis on what we see as weaknesses it creates and threats it gives rise to. These are of particular importance, as we believe they have limited the chiropractic profession’s development. As we shall argue, we believe that these threats have become existential in nature, and we are convinced that they call for a resolute and unified response by the profession. Subsequently, in part II, we discuss various strengths that the chiropractic profession possesses and the opportunities that await, provided that the profession is ready to rise to the challenge.
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Kvammen, Ole C., and Charlotte Leboeuf-Yde. "The chiropractic profession in Norway 2011." Chiropractic & Manual Therapies 22, no. 1 (December 2014). http://dx.doi.org/10.1186/s12998-014-0044-5.
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Abstract Background The chiropractic profession in Norway has increased five-fold in the last two decades. As there is no academic graduate program in Norway, all chiropractors have been trained outside of Norway, in either Europe, America or Australia. This might have given Norwegian chiropractors heterogenic characteristics concerning practice routines and clinical settings. However, little is known about what characterizes this profession and how it compares to other chiropractic professions in Europe. The aim of this survey was to describe major characteristics of the chiropractic profession in Norway. Method Two surveys were distributed to all 530 registered chiropractors in Norway in 2011. One survey was for all chiropractors (Survey 1) and the other for clinic owners (Survey 2). Results have been reported as tables and as approximate percentages in the text for ease of reading. Result Response rates were 61% (Survey 1, N = 320) and 71% (Survey 2, N = 217). More than two-thirds of the chiropractors in Norway had been in practice for under a decade. Only one in four chiropractors worked in solo practice and the majority shared premises with at least one colleague, typically at least one physiotherapist and one additional health practitioner. Today, only one in five clinics possessed radiologic equipment and one in ten had access to diagnostic ultrasound equipment. The majority of the chiropractors reported to apply mainly similar treatment modalities. More than 90% reported to use manipulation techniques on most patients, with soft tissue techniques and exercise modalities being almost as common. More than 3/4 of the profession reported that their clinical practice was in accordance with available clinical guidelines and about one third were positive about participating in future clinical research. Conclusion The Norwegian chiropractic profession is relatively young and members report being satisfied with their work conditions. There is a clear difference from the earlier practice pattern in that intra- and inter-professional collaboration is more common and it is considered desirable. The profession seems to follow the modern trends in evidence-based practice by using X-rays more sparingly than previously, adhering to guidelines and being positive about research.
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Axén, Iben, Cecilia Bergström, Marc Bronson, Pierre Côté, Casper Glissmann Nim, Guillaume Goncalves, Jeffrey J. Hébert, et al. "Misinformation, chiropractic, and the COVID-19 pandemic." Chiropractic & Manual Therapies 28, no. 1 (November 18, 2020). http://dx.doi.org/10.1186/s12998-020-00353-2.
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Abstract Background In March 2020, the World Health Organization elevated the coronavirus disease (COVID-19) epidemic to a pandemic and called for urgent and aggressive action worldwide. Public health experts have communicated clear and emphatic strategies to prevent the spread of COVID-19. Hygiene rules and social distancing practices have been implemented by entire populations, including ‘stay-at-home’ orders in many countries. The long-term health and economic consequences of the COVID-19 pandemic are not yet known. Main text During this time of crisis, some chiropractors made claims on social media that chiropractic treatment can prevent or impact COVID-19. The rationale for these claims is that spinal manipulation can impact the nervous system and thus improve immunity. These beliefs often stem from nineteenth-century chiropractic concepts. We are aware of no clinically relevant scientific evidence to support such statements. We explored the internet and social media to collect examples of misinformation from Europe, North America, Australia and New Zealand regarding the impact of chiropractic treatment on immune function. We discuss the potential harm resulting from these claims and explore the role of chiropractors, teaching institutions, accrediting agencies, and legislative bodies. Conclusions Members of the chiropractic profession share a collective responsibility to act in the best interests of patients and public health. We hope that all chiropractic stakeholders will view the COVID-19 pandemic as a call to action to eliminate the unethical and potentially dangerous claims made by chiropractors who practise outside the boundaries of scientific evidence.