Orthopaedic surgeons, neurologists and neurosurgeons views of the chiropractic profession in South Africa

Abstract

The purpose of this study was to determine the views of orthopaedic surgeons, neurosurgeons and neurologists with regard to the chiropractic profession in South Africa, in order to establish a knowledge base to facilitate greater understanding and thus co-operation between orthodox medicine and chiropractic. A greater understanding of the effectiveness and benefits of chiropractic by the medical profession could lead to greater co-operation between the two professions. This would allow chiropractic to better administer its' services to the public via unprejudiced free market access to patients and organised patient referral systems. A questionnaire with an introductory letter was mailed to the entire population of orthopaedic surgeons, neurosurgeons and neurologists resident in South Africa who were registered with the South African Medical and Dental Council as at 30 June 1995 (N=619). 164 questionnaires were returned in total, constituting a response rate of 26,5%. The survey consisted of questions regarding the respondents general views on chiropractic, chiropractic therapeutic efficacy, chiropractic scope of practice, inter-professional relations, and chiropractic utilization. The results were statistically analyzed using cross-tabulation and chi-square analysis. The results were represented by means of frequency tables and crosstabulation and graphically represented using bar graphs. The majority of South African neurologists, neurosurgeons and orthopaedic surgeons who responded to the survey were not well informed about chiropractic. Although many respondents believed chiropractic to be effective for some patients, a high percentage were still uncomfortable with chiropractic. Significantly, neurosurgeons who responded to the survey were informed to a greater extent about chiropractic and believed it to be more effective than did neurologists and orthopaedic surgeons (p=O,OI05728). A meaningful number of inter-referrals occurs between chiropractors and neurologists, neurosurgeons and orthopaedic surgeons in South Africa. Neurosurgeons also refer more patients to and receive more referrals from chiropractors than do neurologists or orthopaedic surgeons. The majority of respondents to the survey believed that chiropractic is not important in serving in a primary health care capacity and should adopt a supportive and rehabilitative role in the South African health care system. The majority of respondents to the survey also believed that chiropractic is limited to treating neuro-musculo-skeletal problems and that chiropractic should exist either under medical supervision or as a limited medical profession. The sample size (n=164) of this survey negatively affected the statistical significance of the study. Any similar studies conducted in the future should attempt to increase the sample size so as to avoid under-representation of results.