ChiroACCESS Article



The Attitude of Orthopedic Surgeons toward Chiropractors



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ChiroACCESS Editorial Staff

  

ChiroACCESS



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November 17, 2009

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Several surveys of the medical community suggest that collegial interaction and education of other health providers can translate into an effective means of ethically building your practice. The results of a survey of orthopedic surgeons, published and released today by Spine, indicate that opinions about chiropractic vary significantly. Almost a third (29.4%) of the orthopedic surgeons that completed the survey had a favorable view of chiropractic, nearly half (44.5%) were negative and 26.1 percent were neutral. Orthopedic surgeons are perhaps the one medical specialty that competes most directly with the chiropractic profession. Interestingly, 81.8% believed chiropractors could effectively treat some musculoskeletal conditions and have referred patients to chiropractors.

Collegial interactionThe negative view of chiropractic comes primarily from aggressive advertisements, what is perceived to be excessive treatment and creating patient dependency. The criticism regarding excessive treatment is a valid one. However the perception may be due in part to a lack of understanding of chiropractic practice, and the growing use of rehabilitation that requires longer patient care. The criticism of aggressive advertising has also been noted by other chiropractors; particularly those outside the United States. The most important factor that creates a positive impression is direct interprofessional contact between orthopedists and chiropractors.

There are other studies that have examined the attitude of the medical community towards chiropractic. General practitioners among others have a more favorable attitude; and are more likely to refer. A 2001 survey, using a convenience sample of 1200 chiropractors provided a list of 26 potential sources of new patients. These conference attendees indicated that the tenth most productive source for new patients in 2001 was medical referrals.

It seems clear that as the authors note below “Improved interprofessional relations may be important to ensure optimal care of shared patients.” But it also appears that meeting, interacting and educating the medical community can play an important part in ethical practice growth.

Attitudes Toward Chiropractic: A Survey of North American Orthopedic Surgeons.

Spine (Phila Pa 1976). 2009 Nov 11. [Epub ahead of print]

Busse JW, Jacobs C, Ngo T, Rodine R, Torrance D, Jim J, Kulkarni AV, Petrisor B, Drew B, Bhandari M.

STUDY DESIGN.: Questionnaire survey.

OBJECTIVE.: To elicit orthopedic surgeons' attitudes toward chiropractic.

SUMMARY OF BACKGROUND DATA.: Orthopedic surgeons and chiropractors often attend to similar patient populations, but little is known about the attitudes of orthopedic surgeons toward chiropractic.

METHODS.: We administered a 43-item cross-sectional survey to 1000 Canadian and American orthopedic surgeons that inquired about demographic variables and their knowledge and use of chiropractic. Imbedded in our survey was a 20-item chiropractic attitude questionnaire (CAQ).

RESULTS.: 487 surgeons completed the survey (response rate, 49%). North American orthopedic surgeons' attitudes toward chiropractic were diverse, with 44.5% endorsing a negative impression, 29.4% holding favorable views, and 26.1% being neutral. Approximately half of respondents referred patients for chiropractic care each year, mainly due to patient request. The majority of surgeons believed that chiropractors provide effective therapy for some musculoskeletal complaints (81.8%), and disagreed that chiropractors could provide effective relief for nonmusculoskeletal conditions (89.5%). The majority endorsed that chiropractors provide unnecessary treatment (72.7%), engage in overly-aggressive marketing (63.1%) and breed dependency in patients on short-term symptomatic relief (52.3%).In our adjusted generalized linear model, older age (-2.62 points on the CAQ for each 10 year increment; 95% confidence interval [CI] = -3.74 to -1.50), clinical interest in foot and ankle (-2.77; 95% CI = -5.43 to -0.10), and endorsement of the research literature (-4.20; 95% CI = -6.29 to -2.11), the media (-3.05; 95% CI = -5.92 to -0.19), medical school (-7.42; 95% CI = -10.60 to -4.25), or 'other' (-4.99; 95% CI = -8.81 to -1.17) as a source of information regarding chiropractic were associated with more negative attitudes; endorsing a relationship with a specific chiropractor (5.05; 95% CI = 3.00 to 7.10) or residency (3.79;95% CI = 0.17 to 7.41) as sources of information regarding chiropractic were associated with more positive attitudes.

CONCLUSION.: North American orthopedic surgeons' attitudes toward chiropractic range from very positive to extremely negative. Improved interprofessional relations may be important to ensure optimal care of shared patients.
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