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Chiropractic Journal of Australia : CJA June 2012
68 Chiropractic Journal of Australia Volume 42 Number 2 June 2012 INTRODUCTION It is now appropriate for the chiropractic profession to pause and contemplate its position. The profession has succeeded in attaining recognition by way of registration within the Commonwealth of Australia. The legislations for the registration of chiropractors and osteopaths in each and every State and Territory had reverberated throughout the world in the nineteen -seventies and eighties. Australian chiropractic drew universal attention and respect of overseas chiropractic colleges and organisations. At this point in time divisions of thought have been publicly expressed raising the question of evidence based practice and the philosophy of the profession. This commentary has been written to stimulate discussion within the profession. To the author most of the stated attitudes are coming from a minority. There is a need for expression by the silent-majority that is, in general, the practitioners in the feld. It must be said that chiropractors were registered mainly on the basis of their patient support and the service to the community. The chiropractic and osteopathic professions can be pleased with the progress made over the years as registration has been attained in every jurisdiction in Australia and undergraduate -- pre professional training education is within the universities. There is still a long a way to go and the professions need to stand up with the same vigour as demonstrated in the past. Federal registration has brought a whole new set of needs. It requires quality leaders with the necessary vision to take the next steps for full acceptance of the disciplines throughout the health care system. They of course require the support of the entire profession. Discipline specifc national registration was introduced in Australia in July 2010 for registered health professions. Legislative wise, it could be argued that this has placed the Australian chiropractic profession in a stronger position for the drive towards total recognition. There are now four public funded universities involved in conducting chiropractic pre- professional programs, one each in the states of New South Wales, Victoria, Western Australia and a teaching program commencing this year in Mackay, Queensland, Arising from the above is the necessity to assess the required graduate numbers for the community, in the interest of the profession and the direction of the profession through its research and educational processes. The chiropractic profession in Australia has moved over the years from a conglomerate spread of practitioners practising some form of manipulation with varying backgrounds, to a unifed recognised profession. This was due to the backgrounds, visions, efforts, endeavours, dedications and influences of many contributors. It is now up to the members of the profession to treasure those achievements and to carry the profession forward. This brings us to the present position of chiropractic in Australia today. Chiropractic in the work place: Over the years chiropractic has developed on a private practice basis. With the legislative registration position of the practitioners settled and the inclusion of chiropractic courses within universities, the numbers of chiropractors graduating has increased dramatically. The ratio of employment positions for new graduates has not increased correspondingly. Practitioners, who have been in the feld for some time, have reported that their earning potential and average patient numbers has reduced signifcantly. This is despite the fact that the government has recognised the needful role of chiropractic in the health care system, its educational standards and its acceptance by the community at large. It would be a natural assumption that the opposite would be the case and the numbers of people seeking treatment would have increased. Overheads in running a practice, including registration, association fees, professional indemnity insurance, compulsory continuing education development seminar costs, etc have greatly increased. A practice is also an asset and to some it represents a beneft for retirement. Depreciation of that asset could present a loss to the owner, particularly the long term practitioner. Questions arise from the above position. How can this be? It also seems to appear that the employment position has not widened much beyond the historical employment base of private practice. One would expect that the answers will come through the representation activities of the professional associations. The non acceptance of chiropractic and chiropractors within the other traditional health care employment areas such as public hospitals, government departments and health care administration within organisations and bodies, etc. is of concern. All legislation in Australia is enacted on the basis of, “in the public’s interest.” Limiting control of chiropractic treatment through insurance companies and government agencies has also inhibited the benefcial role of chiropractic treatment to patients. Therefore any prevention of the fow on effect of legislative recognition of the profession should be investigated. The task facing the chiropractic profession is succinctly explained in a letter dated 31 August 1989, by The Minister for Community Services and Health, Neal Blewett, in reply to correspondence from E. P. Devereaux, who was then Federal President of the United Chiropractors Association of Australasia, (UCAA). He states: “I see little likelihood at the present time of these services being incorporated in the Medicare program You would be aware that the Medicare Benefts Review (Layton) Committee recommended against Commentary: Current Chiropractic Status in Australia 2012: Manpower and Research Needs
CJA March 2012
CJA September 2012