Research Article
Themes Underlying Australian General Practitioner Views
towards Chiropractic and Osteopathy: An Assessment of Free
Text Data from a Cross-Sectional Survey
Sandra Grace,
1
Roger Engel ,
2
and Ian Jalsion
2
1
School of Health & Human Sciences, Southern Cross University, Military Road, Lismore, NSW 2480, Australia
2
Department of Chiropractic, Macquarie University, Balaclava Road, North Ryde, NSW 2109, Australia
Correspondence should be addressed to Roger Engel; roger.engel@mq.edu.au
Received 21 August 2017; Revised 23 November 2017; Accepted 12 December 2017; Published 14 January 2018
Academic Editor: H. Stephen Injeyan
Copyright © 2018 Sandra Grace et al. Tis is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Te Australian chiropractic and osteopathic professions underwent a period of signifcant transformation between 1960 and 2000.
Tis resulted in an improvement in the views held by the medical profession towards the two professions. However, a recent survey of
Australian general practitioners (GPs) reported that a number of GPs still hold negative views towards chiropractors and osteopaths.
Tis paper examines these views from the perspective of critical realism and explores the generative mechanisms that can infuence
the willingness of health practitioners to collaborate over patient care. A qualitative analysis of open-ended responses to a survey of
630 Australian GPs was conducted. Unfavourable attitudes of GPs towards chiropractors and osteopaths included perceived lack of
safety, efcacy, and inadequacy of training, despite chiropractic’s and osteopathy’s reliance on the same evidence base and similar
training to those of other manual therapy professions such as physiotherapy. Tese attitudes may be underpinned by the professional
biases against chiropractic and osteopathy that continue to marginalise the professions within the Australian healthcare system.
Continued investment in the research base for chiropractic and osteopathic practice is required, along with raising the awareness
of GPs about the education and skills of chiropractors and osteopaths.
1. Introduction
While both chiropractic and osteopathy are formally recog-
nised as allied health professions, their role within the Aus-
tralian healthcare system has not been clearly delineated [1].
Tis may in part be the result of attitudes of Australian general
medical practitioners (GPs) towards the two professions.
Between 1960 and 2000, the chiropractic and osteopathic
professions in Australia underwent a period of signifcant
transformation which included practitioner registration, the
creation of codes of practice, and an upgrade in educational
standards [2–7]. Te period was also characterised by the
amalgamation of a number of smaller professional associa-
tions to form larger associations [8]. Inclusion of chiropractic
and osteopathic services on the Australian Government’s
Medicare Benefts Schedule was granted in 2005 [9] and the
professions were designated as allied health professions soon
afer [10].
Tese changes brought a shif in attitude by sections
of the medical profession in favour of chiropractic and
osteopathy. Some GPs were willing to refer patients for
chiropractic and osteopathic treatment in an attempt to
collaborate over patient care [11–13]. Despite the shif in
attitude, the chiropractic and osteopathic professions failed to
grasp the opportunity to expand their research base through
collaborative projects. Tis may have been due to a lack of
research training and funding within the professions [14]
but also to the view held by some about the methodological
difculties associated with identifying appropriate placebo
controls for testing complex, individualised interventions
such as chiropractic and osteopathy [15, 16]. Tis failure to
increase the level of research lef the professions open to
criticism and scepticism from mainstream medicine.
A recent survey of 630 Australian GPs about their views
towards chiropractors and osteopaths reported that a number
of GPs still hold negative views towards chiropractors and
Hindawi
Evidence-Based Complementary and Alternative Medicine
Volume 2018, Article ID 2786106, 7 pages
https://doi.org/10.1155/2018/2786106