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Glucina TT, Krägeloh CU, Spencer K, Holt K. Development and validation of the Chiropractic Professional Identity Embodiment Scale (CPIES). Complement Ther Clin Pract 2024; 55:101840. [PMID: 38367329 DOI: 10.1016/j.ctcp.2024.101840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 01/21/2024] [Accepted: 02/08/2024] [Indexed: 02/19/2024]
Abstract
BACKGROUND AND PURPOSE Chiropractic professional identity (CPI) encompasses diverse values, beliefs, experiences, and philosophies about one's work, specific to the chiropractic profession. Yet currently, there is no instrument available to measure CPI. This study aimed to develop and validate the Chiropractic Professional Identity Embodiment Scale (CPIES). MATERIALS AND METHODS A mixed-methods sequential exploratory design was employed where qualitative inquiry preceded quantitative analysis of survey items conducted in New Zealand in 2022. Expert key informants provided feedback on candidate items via one-to-one cognitive interviews. Candidate items were administered to Board-registered chiropractors or chiropractic students through an online survey. The suitability of candidate items was evaluated using a variety of psychometric analyses including conceptually guided exploratory factor analysis (EFA) and reliability testing. RESULTS Based on relevant professional identity literature and feedback from 15 expert key informants, a draft survey instrument with 92 candidate items (across six domains) was rated by 231 participants. Using EFA, the number of items was reduced to 15. The CPIES sum score exhibited significant correlations with individuals' philosophical self-categorisation and five of the six optional subscales. CONCLUSION The 15-item CPIES, either as a unidimensional score or with six separate subscale scores, has been demonstrated to provide valid and reliable measurement of CPI. Future research could utilise the CPIES to investigate how CPI influences clinical practice, patient outcomes, career satisfaction, and public perception of the chiropractic profession, further advancing professionalisation and recognition within healthcare.
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Affiliation(s)
- Tanja T Glucina
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland, New Zealand.
| | - Christian U Krägeloh
- Department of Psychology and Neuroscience, Auckland University of Technology, Auckland, New Zealand
| | - Kirsten Spencer
- School of Sport and Recreation, Auckland University of Technology, Auckland, New Zealand
| | - Kelly Holt
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland, New Zealand
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Glucina TT, Krägeloh CU, Spencer K, Holt K. Defining chiropractic professional identity: A concept analysis. J Bodyw Mov Ther 2023; 35:75-83. [PMID: 37330807 DOI: 10.1016/j.jbmt.2023.04.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 01/12/2023] [Accepted: 04/12/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND The concept of professional identity within chiropractic is often discussed and debated, however in the field to date, there is no formal definition of chiropractic professional identity (CPI). This article aims to create a coherent definition of CPI and to formalise the conceptual domains that may encompass it. METHODS Using the Walker and Avant (2005) process, a concept analysis methodology was employed to clarify the diffuse concept of CPI. This method initially involved selecting the concept (CPI), determining the aims and purpose of the analysis, identifying concept uses, and defining attributes. This was achieved from a critical literature review of professional identity across health disciplines. Chiropractic-related model, borderline and contrary cases were used to exemplify characteristics of CPI. The antecedents required to inform CPI, consequences of having, and ways to measure the concept of CPI were evaluated. RESULTS From the concept analysis data, CPI was found to encompass six broad attributes or domains: knowledge and understanding of professional ethics and standards of practice, chiropractic history, practice philosophy and motivations, the roles and expertise of a chiropractor, professional pride and attitude, and professional engagement and interaction behaviours. These domains were not mutually exclusive and may overlap. CONCLUSION A conceptual definition of CPI may bring together members and groups within the profession and promote intra-professional understanding across other disciplines. The CPI definition derived from this concept analysis is: 'A chiropractor's self-perception and ownership of their practice philosophies, roles and functions, and their pride, engagement, and knowledge of their profession'.
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Affiliation(s)
- Tanja T Glucina
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland, New Zealand.
| | - Christian U Krägeloh
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Kirsten Spencer
- School of Sport and Recreation, Auckland University of Technology, Auckland, New Zealand
| | - Kelly Holt
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland, New Zealand
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3
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Innes SI, Cope V, Young KJ. Factors influencing Australian chiropractors who choose not to join national professional associations: a qualitative study. Chiropr Man Therap 2020; 28:58. [PMID: 33256780 PMCID: PMC7704117 DOI: 10.1186/s12998-020-00351-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 10/27/2020] [Indexed: 11/10/2022] Open
Abstract
Background Professional associations (PAs) are perceived to promote their professions and support their members. Despite these advantages, about 1 in 3 Australian chiropractors choose not to belong to either of the two PAs. Our study had two objectives: 1) to explore the views of non-member chiropractors about PAs in general; 2) seek to understand the motivations of non-member Australian chiropractors about not joining a PA. Methods This qualitative descriptive study utilised in-depth semi-structured interviews with open-ended questions for thematic analysis and was conducted from January to April 2020. Nine participants were interviewed before no new themes were articulated. Participants had to be registered chiropractors who had not been members of a PA for at least three years. Recruitment was through a Facebook advertisement and snowball sampling. Interviews were transcribed and imported into NVivo qualitative analysis software, allowing identification of key concepts surrounding non-membership of chiropractic PAs. Results Five themes were identified. 1) A tarnished image, suggested the profession has a poor standing in the eyes of the public and other health professionals. 2) Not worth the money, expressed the annual membership dues were not viewed as good value for money. 3) Going it alone / what’s in it for me? indicated there was no direct benefit or anything deemed essential for practice. 4) Two warring factions, reflected not wanting to be seen to be part of the internal conflict between conservative and evidence-based practitioners. 5) Lack of visibility, described no visible presence or strong communication that clearly displayed the advantages of membership. Conclusions Non-members are looking for PAs to enhance the respectability of the profession in a manner that ultimately results in increased patient volume and the provision of readily accessible day-to-day resources and information. These results can inform the construction of a survey for the broader chiropractic non-membership community to confirm and expand upon these findings and potentially improve PAs. Supplementary Information The online version contains supplementary material available at 10.1186/s12998-020-00351-4.
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Affiliation(s)
- Stanley I Innes
- College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Australia.
| | - Vicki Cope
- College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Australia
| | - Kenneth J Young
- School of Sport and Health Sciences, University of Central Lancashire, Lancashire, England
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4
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Axén I, Bergström C, Bronson M, Côté P, Nim CG, Goncalves G, Hébert JJ, Hertel JA, Innes S, Larsen OK, Meyer AL, O'Neill S, Perle SM, Weber KA, Young KJ, Leboeuf-Yde C. Misinformation, chiropractic, and the COVID-19 pandemic. Chiropr Man Therap 2020; 28:65. [PMID: 33208144 PMCID: PMC7672412 DOI: 10.1186/s12998-020-00353-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 11/05/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND In March 2020, the World Health Organization elevated the coronavirus disease (COVID-19) epidemic to a pandemic and called for urgent and aggressive action worldwide. Public health experts have communicated clear and emphatic strategies to prevent the spread of COVID-19. Hygiene rules and social distancing practices have been implemented by entire populations, including 'stay-at-home' orders in many countries. The long-term health and economic consequences of the COVID-19 pandemic are not yet known. MAIN TEXT During this time of crisis, some chiropractors made claims on social media that chiropractic treatment can prevent or impact COVID-19. The rationale for these claims is that spinal manipulation can impact the nervous system and thus improve immunity. These beliefs often stem from nineteenth-century chiropractic concepts. We are aware of no clinically relevant scientific evidence to support such statements. We explored the internet and social media to collect examples of misinformation from Europe, North America, Australia and New Zealand regarding the impact of chiropractic treatment on immune function. We discuss the potential harm resulting from these claims and explore the role of chiropractors, teaching institutions, accrediting agencies, and legislative bodies. CONCLUSIONS Members of the chiropractic profession share a collective responsibility to act in the best interests of patients and public health. We hope that all chiropractic stakeholders will view the COVID-19 pandemic as a call to action to eliminate the unethical and potentially dangerous claims made by chiropractors who practise outside the boundaries of scientific evidence.
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Affiliation(s)
- Iben Axén
- Karolinska Institutet, Institute of Environmental Medicine, Unit of Intervention and Implementation Research for worker health, Stockholm, Sweden. .,The Norwegian Chiropractic Research Foundation "Et liv I Bevegelse", ELIB, Oslo, Norway.
| | - Cecilia Bergström
- Umeå University, Department of Clinical Sciences, Unit of Obstetrics and Gynecology, Umeå, Sweden
| | - Marc Bronson
- Evidence Based Chiropractic Network, Private practice, Kirkland Lake, Ontario, Canada
| | - Pierre Côté
- Faculty of Health Sciences, Ontario Tech University and Centre for Disability Prevention and Rehabilitation at Ontario Tech University and CMCC, Oshawa, Ontario, Canada
| | - Casper Glissmann Nim
- Spinecentre of Southern Denmark, University Hospital of Southern Denmark, Odense, Denmark.,Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | | | - Jeffrey J Hébert
- Faculty of Kinesiology, University of New Brunswick, Fredericton, Canada.,Discipline of Psychology, Exercise Science, Counselling and Chiropractic, Murdoch University, Perth, Australia
| | | | - Stanley Innes
- Discipline of Psychology, Exercise Science, Counselling and Chiropractic, Murdoch University, Perth, Australia
| | | | | | - Søren O'Neill
- Spinecentre of Southern Denmark, University Hospital of Southern Denmark, Odense, Denmark.,Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Stephen M Perle
- College of Health Sciences, School of Chiropractic, University of Bridgeport, Bridgeport, CT, USA
| | - Kenneth A Weber
- Stanford University School of Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Division of Pain Medicine, Systems Neuroscience and Pain Lab, Palo Alto, California, USA
| | - Kenneth J Young
- University of Central Lancashire, School of Sport and Health Sciences, Preston, UK
| | - Charlotte Leboeuf-Yde
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
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5
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Innes SI, Leboeuf-Yde C, Walker BF. The accreditation role of Councils on Chiropractic Education as part of the profession's journey from craft to allied health profession: a commentary. Chiropr Man Therap 2020; 28:40. [PMID: 32693804 PMCID: PMC7374969 DOI: 10.1186/s12998-020-00329-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 06/09/2020] [Indexed: 11/24/2022] Open
Abstract
Background Chiropractors see themselves as well positioned to provide safe, effective and economical care for the on-going financial burden that spinal pain imposes. However, in many places of the world, the chiropractic profession continues to find itself struggling to gain acceptance as a mainstream allied health care provider. There is evidence of the existence of undesirable chiropractic practice patterns and it is in part due to some of the world’s accredited chiropractic programs. This indicated a need for scrutiny of international chiropractic educational accreditation standards, which are the responsibility of Councils on Chiropractic Education (CCEs). To this end we reviewed an emerging body of evidence about the chiropractic educational system in order to identify issues and make recommendations that may enhance professional acceptance through improved graduate outcomes and hopefully the quality of patient care. This commentary summarises the findings of that research. Main text We reviewed recent relevant studies, including our own, into the role and function of CCEs and found that there is sufficient evidence to identify areas of concern that could be addressed, at least in part, by improvements to CCEs’ educational standards and processes. Areas included a lack of definitions for key terms such as, ‘chiropractic’, ‘diagnosis’, and ‘competency’, without which there can be no common understanding at a detailed level to inform graduate competencies and standards for a matching scope of practice. Further, there is some evidence to suggest that in some cases this level of detail is avoided in order to enable a “big tent” approach that allows for a diversity of approaches to clinical care to co-exist. This combined with the held view that chiropractic is “unique”, highly valued, and best understood by other chiropractors, explains how students and practitioners can cling to ‘traditional’ thinking. This has implications for public safety and patient quality of care. Conclusion If chiropractic care is to gain mainstream acceptance worldwide then it needs to adopt, through revitalised CCE accreditation standards and processes, those of other allied healthcare professions and wholeheartedly embrace science, evidence-based practice and patient centred care.
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Affiliation(s)
- Stanley I Innes
- College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Australia.
| | - Charlotte Leboeuf-Yde
- College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Australia.,Institute for Regional Health Research, University of Southern Denmark, DK-5000, Odense, Denmark
| | - Bruce F Walker
- College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Australia
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Gleberzon BJ, Pohlman KA, Russell E. Comparison of chiropractic student lexicon at two educational institutions: a cross-sectional survey. THE JOURNAL OF THE CANADIAN CHIROPRACTIC ASSOCIATION 2019; 63:36-43. [PMID: 31057176 PMCID: PMC6493211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To evaluate student perceptions of chiropractic cultural authority, role in healthcare and use of terms at two chiropractic institutions, the Canadian Memorial Chiropractic College (CMCC) and Parker University (Parker). METHODS A unique survey was developed and administered electronically to Year 2-3 students (n=387) at CMCC and as a paper-based surveys to trimester 4-5 (comparison with Year 2) and 6-7 (comparison with Year 3) (n=277) students at Parker. Responses were anonymous. The survey assessed the likelihood that students at both chiropractic programs would use eight different chiropractic terms. The survey also assessed their preference toward different options with respect to chiropractic's cultural authority. RESULTS Response rates were 36.2% and 78.1% at CMCC and Parker, respectively. Students at both institutions reported that chiropractic cultural authority was 'neuromusculoskeletal' (NMSK); however, CMCC students was more favorable toward 'musculoskeletal' (MSK) care compared to Parker students, whereas students at Parker favored 'wellness' (59.7%) compared to CMCC students (46.4%). Students at CMCC were more likely to use 'impingement' and 'joint dysfunction' whereas Parker students were more likely to use 'innate intelligence' and 'vertebral subluxation'. Both institutions were equally likely to use 'spinal lesion'. CONCLUSION This survey found significant cultural authority differences between institutions. While this adds to the emerging need in the literature to evaluate the impact of curriculum and co-curriculum within chiropractic training programs on professional identity, explanations were not evaluated.
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Affiliation(s)
- Brian J Gleberzon
- Department of Chiropractic Therapeutics, Canadian Memorial Chiropractic College
- Parker University
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Funk MF, Frisina-Deyo AJ, Mirtz TA, Perle SM. The prevalence of the term subluxation in chiropractic degree program curricula throughout the world. Chiropr Man Therap 2018; 26:24. [PMID: 29988608 PMCID: PMC6027563 DOI: 10.1186/s12998-018-0191-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 04/27/2018] [Indexed: 12/31/2022] Open
Abstract
Background The subluxation construct generates debate within and outside the profession. The International Chiropractic Education Collaboration, comprised of 10 chiropractic programs outside of North America, stated they will only teach subluxation in a historical context. This research sought to determine how many chiropractic institutions worldwide still use the term in their curricula and to expand upon the previous work of Mirtz & and Perle. Methods Forty-six chiropractic programs, 18 United States (US) and 28 non-US, were identified from the World Federation of Chiropractic Educational Institutions list. Websites were searched by multiple researchers for curricular information September 2016–September 2017. Some data were not available on line, so email requests were made for additional information. Two institutions provided additional information. The total number of mentions of subluxation in course titles, technique course (Tech) descriptions, principles and practice (PP) descriptions, and other course descriptions were reported separately for US and non-US institutions. Means for each category were calculated. The number of course titles and descriptions using subluxation was divided by the total number of courses for each institution and reported as percentages. Results Means for use of subluxation by US institutions were: Total course titles = .44; Tech = 3.83; PP = 1.50; other = 1.16. For non-US institutions, means were: Total course titles = .07; Tech = .27; PP = .44; other = 0. The mean total number of mentions was 6.94 in US vs. 0.83 in non-US institutions. Similarly, the mean course descriptions was 6.50 in US vs. 0.72 in non-US institutions. Conclusions The term subluxation was found in all but two US course catalogues. The use of subluxation in US courses rose from a mean of 5.53 in 2011 to 6.50 in 2017. US institutions use the term significantly more frequently than non-US. Possible reasons for this were discussed. Unscientific terms and concepts should have no place in modern education, except perhaps in historical context. Unless these outdated concepts are rejected, the chiropractic profession and individual chiropractors will likely continue to face difficulties integrating with established health care systems and attaining cultural authority as experts in conservative neuro-musculoskeletal health care.
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Affiliation(s)
- Matthew F Funk
- 1University of Bridgeport College of Chiropractic, Bridgeport, CT USA
| | | | - Timothy A Mirtz
- 2Department of Secondary and Physical Education, Bethune-Cookman University, Daytona Beach, FL USA
| | - Stephen M Perle
- 1University of Bridgeport College of Chiropractic, Bridgeport, CT USA.,3Discipline of Chiropractic, School of Health Professions, Murdoch University, Murdoch, WA Australia
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Strahinjevich B, Simpson JK. The schism in chiropractic through the eyes of a 1st year chiropractic student. Chiropr Man Therap 2018; 26:2. [PMID: 29372046 PMCID: PMC5769380 DOI: 10.1186/s12998-017-0171-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 12/20/2017] [Indexed: 11/28/2022] Open
Abstract
Since its inception, the chiropractic profession has been divided along ideological fault lines. These divisions have led to a profession wide schism, which has limited mainstream acceptance, utilisation, social authority and integration. The authors explore the historical origins of this schism, taking time to consider historical context, religiosity, perpetuating factors, logical fallacies and siege mentality. Evidence is then provided for a way forward, based on the positioning of chiropractors as mainstream partners in health care.
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Affiliation(s)
| | - J. Keith Simpson
- Discipline of Chiropractic, Murdoch University, Perth, WA Australia
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9
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Tone as a health concept: An analysis. Complement Ther Clin Pract 2017; 29:27-34. [PMID: 29122266 DOI: 10.1016/j.ctcp.2017.08.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Accepted: 08/10/2017] [Indexed: 11/22/2022]
Abstract
STUDY DESIGN Concept analysis. INTRODUCTION This paper is a report on the analysis of the concept of tone in chiropractic. PURPOSE The purpose of this paper is to clarify the concept of tone as originally understood by Daniel David Palmer from 1895 to 1914 and to monitor its evolution over time. METHODS Data was sourced from Palmer's original work, published between 1895 and 1914. A literature search from 1980 to 2016 was also performed on the online databases CINHAL, PubMed and Scopus with key terms including 'tone', 'chiropractic', 'Palmer', 'vitalism', 'health', 'homeostasis', 'holism' and 'wellness'. Finally hand-searches were conducted through chiropractic books and professional literature from 1906 to 1980 for any references to 'tone'. Rodgers' evolutionary method of analysis was used to categorise the data in relation to the surrogates, attributes, references, antecedents and consequences of tone. RESULTS A total of 49 references were found: five from publications by Palmer; three from the database searches, and; the remaining 41 from professional books, trade journals and websites. MAJOR CONCLUSIONS There is no clear interpretation of tone in the contemporary chiropractic literature. Tone is closely aligned with functional neurology and can be understood as an interface between the metaphysical and the biomedical. Using the concept of tone as a foundation for practice could strengthen the identity of the chiropractic profession.
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Mansholt BA, Salsbury SA, Corber LG, Stites JS. Essential literature for the chiropractic profession: Results and implementation challenges from a survey of international chiropractic faculty. THE JOURNAL OF CHIROPRACTIC EDUCATION 2017; 31:140-163. [PMID: 28768114 PMCID: PMC5656150 DOI: 10.7899/jce-17-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Scientific literature applicable to chiropractic practice proliferates in quantity, quality, and source. Chiropractic is a worldwide profession and varies in scope between states or provinces and from country to country. It is logical to consider that the focus and emphasis of chiropractic education varies between programs as well. This original research study endeavored to determine "essential literature" recommended by chiropractic faculty. The purpose of this article is (1) to share our results and (2) to promote discussion and explore means for future collaboration of chiropractic faculty through a worldwide platform. METHODS A 2-phase recruitment occurred initially at the institutional level and subsequently at the faculty level. A Web-based survey used qualitative data collection methods to gather bibliographic citations. Descriptive statistics were calculated for demographics, and citation responses were ranked per number of recommendations, grouped into categories, and tabulated per journal source and publication date. RESULTS Forty-one chiropractic programs were contacted, resulting in 30 participating chiropractic programs (16 US and 14 international). Forty-five faculty members completed the entire survey, submitting 126 peer-reviewed publications and 25 additional citations. Readings emphasized clinical management of spine pain, the science of spinal manipulation, effectiveness of manual therapies, teaching of chiropractic techniques, outcomes assessments, and professional issues. CONCLUSION A systematic approach to surveying educators in international chiropractic institutions was accomplished. The results of the survey provide a list of essential literature for the chiropractic profession. We recommend establishing a chiropractic faculty registry for improved communication and collaboration.
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Good CJ. Chiropractic Identity in the United States: Wisdom, Courage, and Strength. JOURNAL OF CHIROPRACTIC HUMANITIES 2016; 23:29-34. [PMID: 27920616 PMCID: PMC5127902 DOI: 10.1016/j.echu.2016.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 08/02/2016] [Accepted: 08/02/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE The objective of this paper was to discuss the chiropractic profession's identity and 3 contentious issues related to identity. DISCUSSION The various clinical specialties and independent groups in the chiropractic profession are so different in their beliefs, practice styles, and political agendas that a common identity is unlikely to be created. Areas of disagreement, including advanced practice, vertebral subluxation, and the philosophy of chiropractic, continue to separate those in the profession. Doctors of chiropractic should accept that differences within the profession will remain for the foreseeable future and that the profession should allow each group to live peacefully and supportively alongside each other. CONCLUSIONS If the profession embraces the ideals of truth, respect, and tolerance, it can continue to grow and provide diverse health care services well into the future.
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Affiliation(s)
- Christopher J. Good
- Corresponding author: Christopher J. Good, DC, MA(Ed), University of Bridgeport College of Chiropractic, 175 4th Ave, Stratford, CT 06615. Tel.:+1 315 406 5842.University of Bridgeport College of Chiropractic175 4th AveStratfordCT06615
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12
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Budgell B. Subluxation and semantics: a corpus linguistics study. THE JOURNAL OF THE CANADIAN CHIROPRACTIC ASSOCIATION 2016; 60:190-194. [PMID: 27385839 PMCID: PMC4915476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INTRODUCTION The purpose of this study was to analyze the curriculum of one chiropractic college in order to discover if there were any implicit consensus definitions of the term subluxation. METHODS Using the software WordSmith Tools, the corpus of an undergraduate chiropractic curriculum was analyzed by reviewing collocated terms and through discourse analysis of text blocks containing words based on the root 'sublux.' RESULTS It was possible to identify 3 distinct concepts which were each referred to as 'subluxation:' i) an acute or instantaneous injurious event; ii) a clinical syndrome which manifested post-injury; iii) a physical lesion, i.e. an anatomical or physiological derangement which in most instances acted as a pain generator. CONCLUSIONS In fact, coherent implicit definitions of subluxation exist and may enjoy broad but subconscious acceptance. However, confusion likely arises from failure to distinguish which concept an author or speaker is referring to when they employ the term subluxation.
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Affiliation(s)
- Brian Budgell
- Division of Graduate Education and Research, Canadian Memorial Chiropractic College
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13
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Seaman DR, Soltys JR. Straight chiropractic philosophy as a barrier to Medicare compliance: a discussion of 5 incongruent issues. JOURNAL OF CHIROPRACTIC HUMANITIES 2013; 20:19-26. [PMID: 25067928 PMCID: PMC4111077 DOI: 10.1016/j.echu.2013.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2013] [Revised: 09/22/2013] [Accepted: 09/23/2013] [Indexed: 06/03/2023]
Abstract
OBJECTIVE The purpose of this commentary is to discuss potential 5 factors within straight chiropractic philosophy and practice that may prevent Medicare compliance. DISCUSSION The national Medicare Benefit Policy Manual and the Florida Local Coverage Determination were reviewed to identify documentation and conceptual issues regarding chiropractic practice. Five Medicare positions were contrasted with tenets of straight chiropractic philosophy. Based on Medicare's documentation requirements, Medicare defines subluxation and chiropractic practice from the perspective of treating spinal pain and related functional disability. In contrast, traditional straight chiropractic philosophy is not based on the treatment of spinal pain and disability or other symptomatic presentations. In this context, 5 potential areas of conflict are discussed. CONCLUSION The Medicare version of chiropractic practice is not consistent with traditional straight chiropractic philosophy, which may play a role in preventing Medicare compliance. The chiropractic profession may need to consider the fashion in which "philosophy" as it relates to technique and practice is presented to students and doctors to facilitate compliance with the documentation requirements of Medicare.
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Affiliation(s)
- David R. Seaman
- Professor, National University of Health Sciences, Pinellas Park, FL
| | - Jonathan R. Soltys
- Executive Director, Chiropractic Branch, McKenzie Institute International, Raumati Beach, New Zealand
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Villanueva-Russell Y. Caught in the crosshairs: identity and cultural authority within chiropractic. Soc Sci Med 2011; 72:1826-37. [PMID: 21531061 DOI: 10.1016/j.socscimed.2011.03.038] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2010] [Revised: 03/22/2011] [Accepted: 03/23/2011] [Indexed: 10/18/2022]
Abstract
In this paper the discourse over identity and cultural authority within the profession of chiropractic in the United States has been analyzed using critical discourse analysis. As the profession struggles to construct one singular image, versions of self must be internally debated and also shaped in consideration of larger, external forces. The dilemma of remaining tied to a marginal professional status must be balanced against considerations of integration. Written texts from chiropractic journals and newspapers are analyzed in a multidimensional approach that considers the rhetorical devices and thematic issues of identity construction; the representation of various voices within the discourse (both heard and unheard); and the extent to which external pressures affect the projection of cultural authority for the profession. A heterogeneous discourse characterized by conflict was found, with discrepancies between everyday chiropractors in actual practice versus academic chiropractors and leaders particularly over the idea, practice and significance of science for the profession.
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Affiliation(s)
- Yvonne Villanueva-Russell
- Dept. of Sociology, Texas A&M University-Commerce, Sociology & Criminal Justice, TX 75429-3011, USA.
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