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Chiropractic Journal of Australia : CJA September 2012
88 Chiropractic Journal of Australia Volume 42 Number 3 September 2012 balanced with respect to gender with males making up just over half (55%) of the pool of practitioners.9 A study by Alliet et al20 highlighted that of the small number of chiropractors in Belgium, the majority (55%) were female. Income Chiropractic can be considered an attractive career in terms of fexibility, hours worked and income. This information, combined with data on health service distribution, should be reported to high school careers offces and government employment offces. According to the Australian Bureau of Statistics (ABS), the average income earned per practitioner in 2009-2010, for the chiropractic and osteopathic professions was $108,500.14 This is in the general vicinity of the fgure found in this study of $115,000 for the chiropractic profession only. The average weekly income for a chiropractor is well above the average weekly income for a full-time adult.21 Supply and Demand Qualitative and quantitative information relating to supply and demand enables strategic decision making and planning. It can assist chiropractic training institutions, the Chiropractors’ Association of Australia, the Chiropractors Registration Board of Australian and other stakeholders in making informed decisions about the supply and behaviour of chiropractors in the country. Questions surrounding whether or not there are too many chiropractors in Australia remain diffcult to answer. Table 7 shows a comparison of chiropractor and medical doctor numbers in the US, Canada, Great Britain and Australia.22 It is apparent that chiropractic services are underutilized by the general population compared to the medical profession. This is a sound premise for developing strategies that would build the awareness of chiropractic services to the general public. It is reported that the demographic distribution of the general population in Australia reflects a majority population (including migrants) living in NSW, Victoria and Queensland.23 It is noteworthy that Western Australia, in particular the city of Perth, continues to have the fastest population growth rate in 2010-11.23 Tasmania and South Australia have the highest proportion (15.6%) of people aged 65 years and over. However, the largest increase in people over 65 years of age is occurring in NSW, Victoria and Queensland.23,24 The examination of the supply and demand status for a profession is a diffcult task. There are several reasons for this. Supply and demand are not absolutes. The production of new chiropractors by Australian educational institutions is, by far, the largest source of supply for the chiropractic profession however supply varies across a number of vectors. The issue of adequacy of supply was investigated from a number of perspectives. In this study chiropractors were asked about their perceptions of adequacy of supply in their town and in their state. They were asked if they thought that the Australian schools were producing enough chiropractors or too many. By using the individual experiences of the cohort of respondents, a grass-roots impression could be gained concerning the adequacy of supply of chiropractors in Australia. In most states across Australia, respondents gave quite a differing view about supply in their own state as opposed to their own locality or town. More chiropractors, particularly in South Australia, Western Australia and Queensland thought that there was undersupply in their state but adequate or oversupply in their local region. In the Northern Territory and Tasmania respondents felt there was an undersupply in both their locality and state. In NSW and Victoria there was a clear indication that there was adequate or oversupply in their locality (NSW more so than Victoria) however, the results according to their state were more equal with regard to under and oversupply. Respondents who did not specify their state of origin, and have been coded as ‘missing’ for this question, held a view similar to NSW and Victoria with regard to their perception of whether there is an oversupply or undersupply in their locality or town as opposed to state. These perceptional differences may be attributed to the premise that most of the respondents in this study were from metropolitan areas as opposed to rural and remote areas. These perceptions may be based on the concept that rural and remote areas are underserviced. While the distribution of health services in these areas is less than that of the metropolitan areas, further investigation is required to determine if there is in fact a shortage of chiropractors in rural and remote areas. The evidence provided by this survey offers some tantalizing insights into what chiropractors believe on this issue as well as some more objective pointers to help unravel the issue. Attitudes are shaped by personal experience as well as political imperatives. Neither of these forces rely on objective evidence. Personal experiences may be skewed. The data set revealed that it was common for chiropractors with the same postcode to have opposing beliefs about the adequacy of supply in their town. These beliefs are a mixture of cognition (working the problem out) and emotional overlay. Additionally, the results of surveys on patients and members of the general public on these issues should be triangulated with the data presented here and this would be likely to yield a more rounded perspective. As mentioned, a political imperative also shapes attitudes. A number of chiropractors in open-ended question responses stated that it was important for schools to maintain higher graduation numbers for the purpose of getting the chiropractic message “out there.” Certainly the number of advocates of chiropractic and the number of suppliers of chiropractic services is important considering that market ‘competitors’ outnumber chiropractors.14 Physiotherapy schools produce a far greater number of graduates each year – not surprisingly with 18 Australian universities programs involved.25 Table 7 Doctor Per Population Ratios Country Chiropractors per Unit of Population Medical Doctors per Unit of Population United States Canada Great Britain Australia 2.4 2.1 0.01 2.0 390 390 440 400 Unit = 10,000 members of the population WORK FORCE STUDY SURVEY EATON et al
CJA June 2012
CJA December 2012