The online version of this article (doi:10.1186/1746-1340-18-28) contains supplementary material, which is available to authorized users.
The author is a chiropractor and a full-time, senior lecturer at the Anglo-European College of Chiropractic.
AJH designed the research, performed the literature search, carried out the data collection and analysis, and wrote the manuscript. The research findings reported in this manuscript form part of a larger research thesis undertaken by AJH in completion of a Professional Doctorate.
One of the debates regarding the role of chiropractors is whether or not they should be considered as primary healthcare practitioners. Primary care is often used to describe chiropractic but without any definition of what is meant by the term. Primary healthcare itself has many definitions and this adds to the problem. Existing research literature, based mostly in the USA, suggests that the use of the title "primary healthcare professional" by chiropractors is central to the identity of the profession. It has also been suggested that the concept of primary care is misused by chiropractors because they have not examined the concept in detail and thus do not understand it. For the sake of quality of patient care and for the legitimacy of the profession, chiropractors in the UK need to agree on their healthcare role. This study aimed to examine the opinions of chiropractors towards the use of the term primary healthcare when applied to chiropractic practice within the UK.
A sequential study of exploratory design was used; this model is characterised by an initial phase of qualitative data collection and analysis that precedes and informs the quantitative phase of data collection and analysis. In this study, interviews with members of chiropractic teaching faculty were used to inform the development of a questionnaire used to survey the opinions of chiropractors in the UK.
There was a general consensus of opinion that chiropractors are primary contact practitioners, who work in a primary healthcare setting and that to be able to fulfil this healthcare role, chiropractors must be able to diagnose patients and refer when required. Participants did not feel that chiropractors are able to treat all of the most common medical conditions that present in a primary healthcare setting.
The findings of this study suggest that chiropractors in the UK view their role as one of a primary contact healthcare practitioner and that this view is held irrespective of the country in which they were educated or the length of time in practice.
Further research needs to be developed to evaluate the findings of the current study within a wider healthcare context. In particular the opinions of other healthcare professionals towards the role of chiropractors in healthcare, need to be examined in more detail.
Chapman-Smith D: The regulation of chiropractic practice in Europe. Med Law. 2001, 20 (2): 167-175. PubMed
Baer HA: A Comparative View of a Heterodox Health System: Chiropractic in America and Britain. Medical Anthropology. 1984, 151-168. 10.1080/01459740.1984.9965900. Summer
Duenas R, Carucci GM, Funk MF, Gurney M: Chiropractic - Primary care, neuromusculoskeletal care, or musculoskeletal care? Results of a survey of chiropractic college presidents, chiropractic organization leaders, and Connecticut-licensed Doctors of chiropractic. JMPT. 2003, 26 (8): 510-523. PubMed
Nelson CF: Chiropractic scope of practice. J Manipulative Physiol Ther. 1993, 16 (7): 488-497. PubMed
McCoy M, Schneider M, Pryor M, Numeroff K: A Survey of Chiropractic Students' Knowledge and Attitudes Regarding Diagnosis and Primary Care. The Journal of Chiropractic Education. 2007, 21 (1): 70-71.
Starfield B: Measuring the uniqueness of primary care. J Ambul Care Manage. 1979, 2 (3): 91-99. PubMed
Baldt GA: Primary care: do you qualify?. The Digest of Chiropractic Economics. 1994, March/April: 28-
Wrangler M, Zaugg B, Faigaux E: Medication Prescription: A Pilot Study of Bernese Doctors of Chiropractic Practicing in Switzerland. J Manipulative Physiol Ther. 2010, 3: 231-237. 10.1016/j.jmpt.2010.01.013. CrossRef
British Chiropractic Association: Limited Prescribing Rights. In Touch [Newsletter]. 2009, 142: 4-5.
McCann J, Phillips RL, Green LA, Fryer GE: Chiropractors are not a usual source of primary health care. Am Fam Physician. 2004, 69 (11): 2544- PubMed
American Academy of Family Physicians: Policy & Advocacy: Primary Care. 2008, [Online] [cited 2008 March 3], [ http://aafp.org/online/en/home/policy/policies/p/primarycare.html]
Department of Health (DOH): Primary Care. 2009, [Online] [cited 2009 Aug 2], [ http://www.dh.gov.uk/en/Healthcare/Primarycare/DH_288]
Department of Health (DOH): The Musculoskeletal Services Framework. 2006, [Online] [cited 2010 Aug 6], [ http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4138412.pdf]
Royal Pharmaceutical Society of Great Britain and the British Medical Association: Teamworking in Primary Healthcare: Realising shared aims in patient care. 2000, [Online] [cited 2009 Aug 2], [ http://rpsgb.org.uk/pdfs/teamworking.pdf]
National Institute for Health and Clinical Excellence (NICE): NICE clinical guideline 88. Low back pain: Early management of persistent non-specific low back pain. 2009, [Online] [cited 2010 Mar 31], [ http://nice.org.uk/nicemedia/pdf/CG88NICEGuideline.pdf]
Department of Health (DOH): Equity and excellence: Liberating the NHS. 2010, [Online] [cited 2010 Aug 6], [ http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_117794.pdf]
Creswell JW: Research Design: Qualitative, Quantitative and Mixed Methods Approaches. 2003, London: SAGE Publications
Morse JM: Approaches to qualitative-quantitative methodological triangulation. Nursing Research. 1991, 40 (1): 120-123. PubMed
Ritchie J, Lewis J: Qualitative Research Practice. 2003, London: Sage Publications
Gillham B: Developing a Questionnaire. 2000, London: Continuum International Publishing Group Ltd
Hulley SB, Cummings SR: Designing Clinical Research. 1988, Baltimore: Williams & Wilkins
Barnett K, McLachlan C, Hulbert J, Kassak K: Working together in rural South Dakota: integrating medical and chiropractic primary care. J Manipulative Physiol Ther. 1997, 20 (9): 577-582. PubMed
Hawk C, Dusio ME: A survey of 492 U.S. chiropractors on primary care and prevention-related issues. J Manipulative Physiol Ther. 1995, 18 (2): 57-64. PubMed
Pollentier A, Langworthy JM: The scope of chiropractic practice: A survey of chiropractors in the UK. Clinical Chiropractic. 2007, 10: 147-155. 10.1016/j.clch.2007.02.001. CrossRef
European Council on Chiropractic Education: Accreditation procedures and standards in undergraduate chiropractic education and training. 2009, [Online] [cited 2010 Mar 31], [ http://cce-europe.com/downloads.php]
Norton L: The philosophical bases of grounded theory and their implications for research practice. Nurse Researcher. 1999, 7 (1): 31-43. CrossRef
Charlton R: Research: is an 'ideal' questionnaire possible?. Int J Clin Pract. 2000, 54 (6): 356-359. PubMed
Robson C: Real World Research. 1993, Oxford: Blackwell Publishers Ltd
- Are chiropractors in the uk primary healthcare or primary contact practitioners?: a mixed methods study
Amanda R Jones-Harris
- BioMed Central
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