Dataset Information

The United States Chiropractic Workforce: An alternative or complement to primary care?

ABSTRACT:

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Background

In the United States (US) a shortage of primary care physicians has become evident. Other health care providers such as chiropractors might help address some of the nation's primary care needs simply by being located in areas of lesser primary care resources. Therefore, the purpose of this study was to examine the distribution of the chiropractic workforce across the country and compare it to that of primary care physicians.

Methods

We used nationally representative data to estimate the per 100,000 capita supply of chiropractors and primary care physicians according to the 306 predefined Hospital Referral Regions. Multiple variable Poisson regression was used to examine the influence of population characteristics on the supply of both practitioner-types.

Results

According to these data, there are 74,623 US chiropractors and the per capita supply of chiropractors varies more than 10-fold across the nation. Chiropractors practice in areas with greater supply of primary care physicians (Pearson's correlation 0.17, p-value?ConclusionThese findings suggest that chiropractors practice in areas of greater primary care physician supply. Therefore chiropractors may be functioning in more complementary roles to primary care as opposed to an alternative point of access.

SUBMITTER: Davis MA

PROVIDER: S-EPMC3551710 | biostudies-literature | 2012 Nov

REPOSITORIES: biostudies-literature

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Publications

The United States Chiropractic Workforce: An alternative or complement to primary care?

Davis Matthew A MA Mackenzie Todd A TA Coulter Ian D ID Whedon James M JM Weeks William B WB

Chiropractic & manual therapies 20121121 1

<h4>Unlabelled</h4><h4>Background</h4>In the United States (US) a shortage of primary care physicians has become evident. Other health care providers such as chiropractors might help address some of the nation's primary care needs simply by being located in areas of lesser primary care resources. Therefore, the purpose of this study was to examine the distribution of the chiropractic workforce across the country and compare it to that of primary care physicians.<h4>Methods</h4>We used nationally ...[more]

PMID: 23171540

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Project description:BackgroundThe world is faced with a chronic shortage of health workers, and the World Health Organization (WHO) has estimated a global shortage of 7.2 million health workers resulting in large gaps in service provision for people with disability. The magnitude of the unmet needs, especially within musculoskeletal conditions, is not well established as global data on health work resources are scarce.MethodsWe conducted an international, cross-sectional survey of all 193 United Nation member countries and seven dependencies to describe the global chiropractic workforce in terms of the availability (numbers and where they are practising), quality (education and licensing), accessibility (entry and reimbursement), and acceptability (scope of practice and legal rights). An electronic survey was issued to contact persons of constituent member associations of the World Federation of Chiropractic (WFC). In addition, data were collected from government websites, personal communication and internet searches. Data were analysed using descriptive statistics. Worldwide density maps of the distribution of numbers of chiropractors and providers of chiropractic education were graphically presented.ResultsInformation was available from 90 countries in which at least one chiropractor was present. The total number of chiropractors worldwide was 103,469. The number of chiropractors per country ranged from 1 to 77,000 (median = 10; IQR = [4-113]). Chiropractic education was offered in 48 institutions in 19 countries. Direct access to chiropractic services was available in 81 (90%) countries, and services were partially or fully covered by government and/or private health schemes in 46 (51.1%) countries. The practice of chiropractic was legally recognized in 68 (75.6%) of the 90 countries. It was explicitly illegal in 12 (13.3%) countries.ConclusionWe have provided information about the global chiropractic workforce. The profession is represented in 90 countries, but the distribution of chiropractors and chiropractic educational institutions, and governing legislations and regulations largely favour high-income countries. There is a large under-representation in low- and middle-income countries in terms of provision of services, education and legislative and regulatory frameworks, and the available data from these countries are limited.

Project description:BackgroundSpine related disorders entail biological (somatic), psychological, and social factors. Though biological factors are often emphasized, psychosocial considerations may not be receiving proper attention in the chiropractic field. Chiropractors treat spine complaints and therefore should be trained in the full spectrum of the biopsychosocial model. This study examines the use of psychosocial related terminology in United States doctor of chiropractic program (DCP) curricula, the Council on Chiropractic Education (CCE) standards, and the National Board of Chiropractic Examiners (NBCE) test plans.MethodsNineteen academic course catalogs, CCE curricular standards and meta-competencies, and NBCE test plans were studied. Terms containing "psycho", "soci", "mental", "econom", "cultur", "emotion", "determinant", "public", "communit", "neighbor", "behav", or "cognitive" were identified in each document. Frequency of use, context of use, thematic categorization, and percentage of use compared to overall content were calculated and described.Results'Public' is the most commonly used psychosocial related term in DCP curricula. 'Determinant' was used in 1 DCP curriculum. The number of courses with psychosocial related terminology in course titles and course descriptions ranged from 1 to 5 and 3 to 12, respectively. Most terms are found in clinical skills, special populations, and other miscellaneous courses, with fewer terms found in psychology and public health courses. Terminology use in course titles and descriptions compared to overall content ranges from 3.40 to 14.86%. CCE uses terminology 17 times across 5 (out of 8) total meta-competencies. NBCE includes terminology in test plans I and II, but not III or IV.ConclusionsDespite evidence suggesting the influential role of psychosocial factors in determinants of health and healthcare delivery, these factors are poorly reflected in United States DCP curricula. This underappreciation is further evidenced by the lack of representation of psychosocial terminology in NBCE parts III and IV test plans. The reasons for this are theoretical; lack of clarity or enforcement of CCE meta-competencies may contribute.

Dataset Information

The United States Chiropractic Workforce: An alternative or complement to primary care?

Unlabelled

Background

Methods

Results

Publications

The United States Chiropractic Workforce: An alternative or complement to primary care?

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