Chiropractic Identity, Role and Future: A Survey of North American Chiropractic Students
Written by Editor   
Monday, September 19, 2016 12:00 AM

The last thirty years in health care have brought about many changes: an emphasis on cost-effective treatments and interprofessional collaboration, an increase in medical specialization and sub-specialization, the concept and implementation of evidence-based practice, and a greater acceptance of complementary and alternative medicine (CAM) therapies in mainstream medicine. Amid all of these transformations and shifts in the health care arena, a primary spine care specialist role has not been established.

The literature pertaining to chiropractic students’ opinions with respect to the desired future status of the chiropractic physician is limited. A previous pilot study was performed at a single chiropractic college. This study is an expansion of this pilot project to collect data from chiropractic students enrolled in colleges throughout North America.  The purpose of the study is to investigate North American chiropractic students’ opinions concerning professional identity, role and future.

Most respondents agreed (34.8%) or strongly agreed (52.2%) that it is important for chiropractors to be educated in evidence-based practice. A majority agreed (35.6%) or strongly agreed (25.8%) the emphasis of chiropractic intervention is to eliminate vertebral subluxations/vertebral subluxation complexes. A large number of respondents (55.2%) were not in favor of expanding the scope of the chiropractic profession to include prescribing medications with appropriate advanced training. Most respondents estimated that chiropractors should be considered mainstream health care practitioners (69.1%). Several respondents (46.8%) think that chiropractic research should focus on the physiological mechanisms of chiropractic adjustments.

The study reports that the current state of spinal care has been classified as a “supermarket approach” consisting of multiple practitioners including primary care providers, chiropractic physicians, acupuncturists, physical therapists, physiatrists, orthopedic surgeons, neurosurgeons, massage therapists, and naturopathic physicians with multiple treatment philosophies, high salesmanship and little interprofessional communication.  Chiropractic physicians possess many attributes that would be required of a primary spine care practitioner, and with specific modifications in education and practice, chiropractors may be in a position to make a relatively lateral transition to occupy this role. 

A 23-item cross-sectional electronic questionnaire was developed. A total of 7,455 chiropractic students from 12 North American English-speaking chiropractic colleges were invited to complete the survey. Survey items encompassed demographics, evidence-based practice, chiropractic identity and setting, and scope of practice. Data were collected and descriptive statistical analysis was performed.