How can chiropractic become a respected mainstream profession? The example of podiatry

Abstract

BackgroundThe chiropractic profession has succeeded to remain in existence for over 110 years despite the fact that many other professions which had their start at around the same time as chiropractic have disappeared. Despite chiropractic's longevity, the profession has not succeeded in establishing cultural authority and respect within mainstream society, and its market share is dwindling. In the meantime, the podiatric medical profession, during approximately the same time period, has been far more successful in developing itself into a respected profession that is well integrated into mainstream health care and society.ObjectiveTo present a perspective on the current state of the chiropractic profession and to make recommendations as to how the profession can look to the podiatric medical profession as a model for how a non-allopathic healthcare profession can establish mainstream integration and cultural authority.DiscussionThere are several key areas in which the podiatric medical profession has succeeded and in which the chiropractic profession has not. The authors contend that it is in these key areas that changes must be made in order for our profession to overcome its shrinking market share and its present low status amongst healthcare professions. These areas include public health, education, identity and professionalism.ConclusionThe chiropractic profession has great promise in terms of its potential contribution to society and the potential for its members to realize the benefits that come from being involved in a mainstream, respected and highly utilized professional group. However, there are several changes that must be made within the profession if it is going to fulfill this promise. Several lessons can be learned from the podiatric medical profession in this effort.

Assessing the change in attitudes, knowledge, and perspectives of medical students towards chiropractic after an educational intervention*

“…[15][16][17][18][19][20] The chiropractic profession reportedly has been viewed as having poor ethics and dishonesty when compared to other health care professions. 21 Organizations and authors have identified the lack of integration with mainstream health care as a major challenge for the chiropractic profession and have suggested strategies to overcome this barrier. [21][22][23] Proposed strategies included chiropractors focusing on public health initiatives, chiropractic educational reform, interdisciplinary training, and interprofessional collaboration.…”

“…21 Organizations and authors have identified the lack of integration with mainstream health care as a major challenge for the chiropractic profession and have suggested strategies to overcome this barrier. [21][22][23] Proposed strategies included chiropractors focusing on public health initiatives, chiropractic educational reform, interdisciplinary training, and interprofessional collaboration. [21][22][23] One potential barrier to the integration of chiropractic into mainstream health care has been the negative perceptions of physicians towards chiropractic.…”

“…[21][22][23] Proposed strategies included chiropractors focusing on public health initiatives, chiropractic educational reform, interdisciplinary training, and interprofessional collaboration. [21][22][23] One potential barrier to the integration of chiropractic into mainstream health care has been the negative perceptions of physicians towards chiropractic. [24][25][26] This barrier may be more evident among physicians who attend to the same patient population as chiropractors, including family physicians and orthopedic surgeons.…”

A qualitative exploration of chiropractic and physiotherapy teachers' experiences and conceptualizations of the educational environment

“…31 Scholars have pointed out that the absence of a university-style tradition, coupled with a lack of access to government funding, has acted as a barrier to the development of the chiropractic profession. 32,33 The chiropractic teachers experienced their program as having been built, over several decades, independently of the large publicly funded university tradition, with all its pros and cons. Hence, the teachers' experience was that the program has had to rely exclusively on its own resources, thus developing a dandelion profession that managed on its own.…”

Research mentoring: Suggestions and encouragement from a reflection exercise

“…4 For decades, authors from within the chiropractic profession have called for the development of formally trained chiropractic researchers. 5 One factor in this change is that as new chiropractic teaching institutions around the world are being created within existing universities, the opportunities for research training and mentorship are increasing.…”