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Chiropractic Journal of Australia : CJA September 2012
120 Chiropractic Journal of Australia Volume 42 Number 3 September 2012 Table 21 Prevalence of Complaints at the Chiropractic Clinic Complaint Percentage (%) Standard Deviation (SD) Lower Back Symptoms 29.5 0.18 Neck Symptoms 24.3 0.16 Thoracic Region Symptoms 10.5 0.11 Rib Symptoms 3.5 0.05 Headaches 12.0 0.09 Upper Limb Symptoms 7.9 0.07 Lower Limb Symptoms 7.8 0.10 Preventative Treatment / Wellness Type Care 5.8 0.20 Other 7.4 0.19 Table 22 Most Common Presenting Complaint Amongst Patients Type of Complaint Relative Frequency (%) Pediatrics 17.24 Musculoskeletal 32.76 Women's Health 10.77 Sporting Injuries 12.5 Geriatrics 13.36 Other 2.15 Missing 11.21 Total 100.0 a referral system in place (Table 18). Over half (52.2%) of respondents indicated that they did have a referral system in operation. Respondents were then questioned regarding the type of practitioner/s that was on their referral list (Table 19). Four types of practitioner were frequently incorporated into the referral system; 62.6% of the chiropractors with referral systems in place referred patients to general practitioners, 36.6% to massage therapists, 28.5% to naturopaths, and the same proportion referred patients to podiatrists. Acupuncturists, dentists, and physiotherapists also featured prominently among the responses. Based on the results of this survey, house calls do not seem to be very common among chiropractors in NSW. In fact, 82% of the chiropractors surveyed did not make any house calls during a usual week (Table 20). The survey asked practitioners to estimate the percentage of their patients that present with particular problems each week. The responses were quite varied (Table 21). The most common problem observed was lower back symptoms (29.5% of patients on average), followed by neck symptoms (24.3%). Preventative treatment (15.8%) and headaches (12.0%) were also commonly observed problems. Practitioners were asked if there were any common characteristics among the patients that they treated in their clinics (Table 22). While there were no obvious patterns in combinations of characteristics, the responses show that standard musculoskeletal complaints (25.5% of chiropractors indicating this as a common characteristic) were the most frequently encountered problem among chiropractic patients. Seventeen percent (17.4%) of chiropractors indicated pediatrics as a common patient group, followed by geriatrics, sporting injuries and women’s health. DISCUSSION This study is the frst comprehensive description of NSW chiropractic practitioners and their patients. The survey was wide-ranging providing information on demographics, ethnicity, education, work practices, income, sources of patients, referral patterns, and patient characteristics. In general, the sociodemographic characteristics of both chiropractic practitioners and their associated patients are in line with other previous published studies from other countries from the UK, 3,16 North America4 and Switzerland8 with similarities with other European countries. 6,7,17 Of note, 76% of respondents in NSW were male which is similar to that reported in US (82%),4 and Switzerland (71%).8 This is in contrast however with the gender balance in the UK chiropractic profession which is a little more evenly distributed (55% males). 16 It would therefore seem that chiropractic in NSW as with most other countries is a male dominated profession. Although the average working week in Australia is between 35 and 40 hours, 31% of NSW chiropractors reported working more than 40 hours per week. This is similar to 30% in the US but lower than the 43% reported from the Swiss study.8 Within NSW, just over a third of the respondents (34%) worked less than 29 hours per week. With regard to income, the average pre-tax income was highly variable. Less than a third (20.5%) of practitioners earn an average pre-tax income of less than $64,000, with over a third of respondents (42%) earning over $115,000. It is interesting that the majority of respondents in this study reported that they were at their current and previous practices for less than fve years. It could be the case that the chiropractic profession is highly mobile if this sample is refective of the greater chiropractic population. This point however requires further exploration. It can be said that chiropractic is a very attractive career prospect, with clinicians earning higher than the national Australian average income and working fewer hours in the working week. More than half (58.2%) of the respondents indicated that they had a referral system in place. Utilising a multidisciplinary referral network requires good communication strategies including the use of a shared vocabulary. According to the results of this survey, ‘word of mouth’ advertising is a key source of patient referral. This particular pattern appears to be common around the world3,4,8 and may potentially lead to the notion that chiropractic services in NSW are consumer driven. Professional chiropractic stakeholders should keep this in mind when promoting and educating the general public about CHIROPRACTIC PRACTICE IN NEW SOUTH WALES EATON et al
CJA June 2012
CJA December 2012