Differences in Outcomes Between Male vs Female DCs
Written by Editor   
Thursday, September 14, 2017 12:01 PM

The number of practicing male doctors of chiropractic (DCs) in Switzerland currently exceeds the number of female DCs, with men making up about 70% of the profession, according to the Swiss Chiropractic Association, Chirosuisse. However, this sex ratio is not mirrored in the student body at the University of Zürich Chiropractic Medicine program, where currently 75% of students are female. Comparatively, since 2004, the percentage of female graduates in Swiss medical schools has been consistently >50% and rose to >60% in 2009. This phenomenon, known as the feminization of medicine, is a much discussed topic within the medical profession and academia.

This prospective cohort study with 1-year follow-up reports a  significantly higher proportion of patients of female DCs reported clinically relevant improvement at 1 week, 3 months, and 1 year, and had a significantly greater decrease in their pain scores compared with male DCs’ patients at 1 week. However, female DCs also had a significantly greater number of acute patients (who have been reported to improve faster and with greater magnitude than subacute or chronic patients) compared with male DCs.  When evaluating the chronic and subacute subgroups alone, there was no significant difference in treatment outcome between male and female DCs. This suggests that patient outcomes of improvement and satisfaction may be more likely influenced by other factors associated with low back pain.

The study recruited a total of 1095 adult patients with low back pain (LBP) of any duration who had not received chiropractic or manual therapy in the prior 3 months.  All 286 active members of the Swiss Chiropractic Association were asked to contribute patients to this study. 

Patients were contributed by 66 of the 286 members of the Swiss Chiropractic Association. The study found that female DCs had significantly more acute patients (pain duration <4 weeks) than male DCs, who see more subacute and chronic patients (pain duration >4 weeks). Radiculopathy was present significantly more often in patients of male DCs.

Chiropractic in Switzerland is 1 of the 5 government-recognized and -regulated medical professions (medicine, dental medicine, veterinary medicine, pharmacology, and chiropractic) and is reimbursed under the mandatory national sickness and accident insurance programs, the same as medicine. In 2008, the University of Zürich started the first chiropractic medicine program in Switzerland, which is part of its faculty of medicine. Students of chiropractic medicine are considered part of the medical student population and have the same admission process and criteria and also the same basic curriculum and exam requirements for the first 4 years. 

Source:  http://www.jmptonline.org/article/S0161-4754(17)30128-8/abstract