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Chiropractic Journal of Australia : CJA September 2012
Chiropractic Journal of Australia Volume 42 Number 3 September 2012 87 WORK FORCE STUDY SURVEY EATON et al Furthermore, most of the respondents who said that there was an adequate number of chiropractors in their state felt that the current rate of production was too high. This might be interpreted to mean that current levels are adequate but continued production of new graduates will lead to oversupply in their state. Amongst those who stated that they did not know if their state had too many or too few chiropractors, most thought that the schools were producing an adequate number of graduates. DISCUSSION Complementary and alternative medicine (CAM) therapists such as chiropractors, naturopaths and acupuncturists are relatively small occupational groups but have become an increasingly popular occupation choice over the last few decades.2 Reasons for this are varied including an increased interest in alternate lifestyles,2 and a greater exposure to eastern philosophy via China through an increase in immigration and trade.15 At the end of June 2010 there were 11,440 persons engaged in the chiropractic and osteopathic service industry.14 According to the census, there were 8,600 people employed as complementary health therapists in 2006 which was almost 80% higher than the number in 1996. The leading occupations were naturopaths (2,980) and chiropractors (2,490), demonstrating a growth of 56% and 45% respectively from 1996. Overall, the Australian population increased by 12% and the total number of health professionals rose by 31%.2 Xue et al 3 provided estimates, for the Australian population, of expenditure on visits to CAM therapists to be around AUD $1.73 billion between 04-05. The total estimated Australian expenditure on CAM treatments and related products was AUD $4.13 billion for that period. The national expenditure on CAM accounts for approximately half the total expenditure on non-subsidised health care products. Furthermore, Xue and colleagues3 estimate that Australians visit CAM practitioners almost as often as they visit medical practitioners. The organized profession, armed with such data can better target its strategic planning in promoting the profession. Entreaties to political groups could be better informed, basing its arguments on evidence rather than hopes and aspirations. On the other hand, the profession is not static and, given the rapidly changing internal and external environment, it is likely that the trends occurring within the profession will change in the future. For example, factors that may directly or indirectly impact on the profession for future planning include legislation and policy, research, integration or collaboration of chiropractic into mainstream health, and advancing technology. A scan of the internal and external environment as well as liaison with key stakeholders is necessary to assist with future planning for the chiropractic profession. Demographic Characteristics Strategic planning and goal setting for chiropractic and health care in general, should factor in population trends in general and the impact on the health care system by the growing ageing population. Seventy percent (70%) of respondents in this study live and work in metropolitan areas, while the remaining 30% are living and working in rural and remote areas. This is similar with the distribution pattern of the general population where growth continues to be most prominent in inner-city areas, outer suburbs, urban infll areas and along the coast.16 Areas that have seen a decline in population include inland rural areas that have been affected by drought in the last few years.16 This matches the distribution of healthcare services in Australia with approximately 75% of healthcare services being located in metropolitan areas.14 Therefore, it remains apparent that with regard to health care, the inland, rural and remote areas continue to be underserviced. Long-term planning should include a framework that allows a greater provision in health care services, including chiropractic care. Chiropractic education providers would also beneft students by orientating aspects of the curriculum towards rural health services. Most respondents to this survey were from NSW and Victoria (Figure 2). This is consistent with the current Australian census for chiropractors.14 The preponderance of chiropractor numbers in NSW and Victoria refects the fact that there have been chiropractic schools in those two states for over 50 years. It is likely that a higher percentage of graduates establish their practices near their school of graduation. Other states have only had short term, sporadic chiropractic training offerings. Gender Implications A larger proportion of female respondents were in the under 30 year age group and the 30-50 year age groups compared to males. This suggests that when gender and state distribution are viewed in light of practitioner age, there may be an evolution of the profession towards an increasingly female bias over time. There is a consistent historical trend that women predominate or account for almost half of those who work in complementary therapies such as naturopaths (79%), homeopaths (76%), acupuncturists and osteopaths (49%), while men predominate in traditional Chinese medicine and chiropractic.2 It seems apparent that the results of this study are consistent with the current social trends, however it is clear that the proportion of women in Australia studying chiropractic and entering the chiropractic workforce is steadily increasing. A similar trend has been observed in the US from the periods 1991-2009.17 There is a greater tendency for women to enter into part-time work as this is a means of combining the responsibilities of young children with paid employment.18 Having said this, it is noteworthy that results from the Australian Family Project show that part-time work has also become increasingly important for single and married women without young children. These factors affect the supply of chiropractic services so that, although the number of registered female chiropractors may be increasing, the supply of services will not be increasing at the same rate. Interestingly, male chiropractors work an average of 4 hours per week longer than females and consult with more patients per week. The chiropractic profession in Australia is predominantly male (66%) at this point in time. These fndings are consistent with other job analysis studies. In Switzerland, male practitioners make up 71% of the chiropractic workforce 10 and in Finland this fgure was 80%.19 In 2009, males made up approximately 78% of the total chiropractors in the United States.17 Interestingly, the UK chiropractic workforce seems to be somewhat more
CJA June 2012
CJA December 2012