Moving towards a contemporary chiropractic professional identity

Glucina, Tanja T.; Krägeloh, Christian U.; Farvid, Panteá; Holt, Kelly

doi:10.1016/j.ctcp.2020.101105

Cited by 15 publications

(14 citation statements)

References 85 publications

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“…sees it role as promoting evidence-based chiropractic care and inter-professional cooperation in order to improve community health through high quality, patientfocused care and has policy statements on subluxation as a historical concept, not supported by any clinical research evidence [44]. It is generally thought that the MSK and non-MSK factions exist as polar extremes with the majority falling somewhere in the middle [45]. The two factions strongly defend their own position and question the other's paradigm [46][47][48], to the extent that a recent discussion paper proposed that these differences were irreconcilable and the profession should consider divorcing along these lines [46].…”

Section: Theme 4: Two Warring Factionsmentioning

confidence: 99%

Factors influencing Australian chiropractors who choose not to join national professional associations: a qualitative study

2020

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Background Professional associations (PAs) are perceived to promote their professions and support their members. Despite these advantages, about 1 in 3 Australian chiropractors choose not to belong to either of the two PAs. Our study had two objectives: 1) to explore the views of non-member chiropractors about PAs in general; 2) seek to understand the motivations of non-member Australian chiropractors about not joining a PA. Methods This qualitative descriptive study utilised in-depth semi-structured interviews with open-ended questions for thematic analysis and was conducted from January to April 2020. Nine participants were interviewed before no new themes were articulated. Participants had to be registered chiropractors who had not been members of a PA for at least three years. Recruitment was through a Facebook advertisement and snowball sampling. Interviews were transcribed and imported into NVivo qualitative analysis software, allowing identification of key concepts surrounding non-membership of chiropractic PAs. Results Five themes were identified. 1) A tarnished image, suggested the profession has a poor standing in the eyes of the public and other health professionals. 2) Not worth the money, expressed the annual membership dues were not viewed as good value for money. 3) Going it alone / what’s in it for me? indicated there was no direct benefit or anything deemed essential for practice. 4) Two warring factions, reflected not wanting to be seen to be part of the internal conflict between conservative and evidence-based practitioners. 5) Lack of visibility, described no visible presence or strong communication that clearly displayed the advantages of membership. Conclusions Non-members are looking for PAs to enhance the respectability of the profession in a manner that ultimately results in increased patient volume and the provision of readily accessible day-to-day resources and information. These results can inform the construction of a survey for the broader chiropractic non-membership community to confirm and expand upon these findings and potentially improve PAs.

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Section: Theme 4: Two Warring Factionsmentioning

confidence: 99%

Factors influencing Australian chiropractors who choose not to join national professional associations: a qualitative study

2020

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“…Instead, the chiropractors aimed to locate and correct areas of spinal dysfunction, or CSMC problems [ 15 , 17 ], as this is thought to improve the central integration of somatosensory input from the spine and body [ 13 ]. CSMC problems can be reliably detected in relatively healthy populations [ 33 ], and a broad range of people in the community seek chiropractic care for wellness care or a range of conditions and issues [ 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 ]. Therefore, the chiropractic care in the present study did not markedly differ from the care that a chiropractor may provide to a patient who had not suffered from a stroke.…”

Section: Discussionmentioning

confidence: 99%

The Effects of 4 Weeks of Chiropractic Spinal Adjustments on Motor Function in People with Stroke: A Randomized Controlled Trial

et al. 2021

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Chiropractic spinal adjustments have been shown to result in short-term increases in muscle strength in chronic stroke patients, however, the effect of longer-term chiropractic spinal adjustments on people with chronic stroke is unknown. This exploratory study assessed whether 4 weeks of chiropractic spinal adjustments, combined with physical therapy (chiro + PT), had a greater impact than sham chiropractic with physical therapy (sham + PT) did on motor function (Fugl Meyer Assessment, FMA) in 63 subacute or chronic stroke patients. Secondary outcomes included health-related quality of life and other measures of functional mobility and disability. Outcomes were assessed at baseline, 4 weeks (post-intervention), and 8 weeks (follow-up). Data were analyzed using linear mixed-effects models or generalized linear mixed models. A post-hoc responder analysis was performed to investigate the clinical significance of findings. At 4 weeks, there was a larger effect of chiro + PT, compared with sham + PT, on the FMA (difference = 6.1, p = 0.04). The responder analysis suggested the improvements in motor function seen following chiropractic spinal adjustments may have been clinically significant. There was also a robust improvement in both groups in most measures from baseline to the 4- and 8-week assessments, but between-group differences were no longer significant at the 8-week assessment. Four weeks of chiro + PT resulted in statistically significant improvements in motor function, compared with sham + PT, in people with subacute or chronic stroke. These improvements appear to be clinically important. Further trials, involving larger group sizes and longer follow-up and intervention periods, are required to corroborate these findings and further investigate the impacts of chiropractic spinal adjustments on motor function in post-stroke survivors. ClinicalTrials.gov Identifier NCT03849794.

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“…The 'traditional' or 'conservative' beliefs result in practitioners, who hold that a wide range of diseases and musculoskeletal complaints will be helped or prevented by removal of nerve interference [42,43]. The most recent figures suggest that at least 20% of chiropractors have this exclusive vertebral subluxation focus, and even up to 70% believe this concept may be an important practice consideration [44]. This pattern of thinking was found to be more prevalent in graduates from certain CPs, suggesting that the regulation of chiropractic education may be a significant factor [19].…”

Section: Main Textmentioning

confidence: 99%

The accreditation role of Councils on Chiropractic Education as part of the profession's journey from craft to allied health profession: a commentary

2020

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Background: Chiropractors see themselves as well positioned to provide safe, effective and economical care for the ongoing financial burden that spinal pain imposes. However, in many places of the world, the chiropractic profession continues to find itself struggling to gain acceptance as a mainstream allied health care provider. There is evidence of the existence of undesirable chiropractic practice patterns and it is in part due to some of the world's accredited chiropractic programs. This indicated a need for scrutiny of international chiropractic educational accreditation standards, which are the responsibility of Councils on Chiropractic Education (CCEs). To this end we reviewed an emerging body of evidence about the chiropractic educational system in order to identify issues and make recommendations that may enhance professional acceptance through improved graduate outcomes and hopefully the quality of patient care. This commentary summarises the findings of that research. Main text: We reviewed recent relevant studies, including our own, into the role and function of CCEs and found that there is sufficient evidence to identify areas of concern that could be addressed, at least in part, by improvements to CCEs' educational standards and processes. Areas included a lack of definitions for key terms such as, 'chiropractic', 'diagnosis', and 'competency', without which there can be no common understanding at a detailed level to inform graduate competencies and standards for a matching scope of practice. Further, there is some evidence to suggest that in some cases this level of detail is avoided in order to enable a "big tent" approach that allows for a diversity of approaches to clinical care to co-exist. This combined with the held view that chiropractic is "unique", highly valued, and best understood by other chiropractors, explains how students and practitioners can cling to 'traditional' thinking. This has implications for public safety and patient quality of care. Conclusion: If chiropractic care is to gain mainstream acceptance worldwide then it needs to adopt, through revitalised CCE accreditation standards and processes, those of other allied healthcare professions and wholeheartedly embrace science, evidence-based practice and patient centred care.

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Moving towards a contemporary chiropractic professional identity

Cited by 15 publications

References 85 publications

Factors influencing Australian chiropractors who choose not to join national professional associations: a qualitative study

Factors influencing Australian chiropractors who choose not to join national professional associations: a qualitative study

The Effects of 4 Weeks of Chiropractic Spinal Adjustments on Motor Function in People with Stroke: A Randomized Controlled Trial

The accreditation role of Councils on Chiropractic Education as part of the profession's journey from craft to allied health profession: a commentary

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