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Open Access Research

The United States Chiropractic Workforce: An alternative or complement to primary care?

Matthew A Davis1*, Todd A Mackenzie2, Ian D Coulter3, James M Whedon4 and William B Weeks4

Author Affiliations

1 Center for Health Policy Research, The Dartmouth Institute for Health Policy & Clinical Practice, 35 Centerra Parkway, Lebanon, NH, 03766, USA

2 The Dartmouth Institute for Health Policy & Clinical Practice, 35 Centerra Parkway, Lebanon, NH, 03766, USA

3 University of California at Los Angeles, CA, Senior Health Policy Analyst, RAND Corporation, Santa Monica, CA, 90401, USA

4 Geisel School of Medicine at Dartmouth, Section of Clinical Research, HB 7505, Dartmouth Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH, 03766, USA

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Chiropractic & Manual Therapies 2012, 20:35  doi:10.1186/2045-709X-20-35

Published: 21 November 2012

Abstract

Background

In the United States (US) a shortage of primary care physicians has become evident. Other health care providers such as chiropractors might help address some of the nation’s primary care needs simply by being located in areas of lesser primary care resources. Therefore, the purpose of this study was to examine the distribution of the chiropractic workforce across the country and compare it to that of primary care physicians.

Methods

We used nationally representative data to estimate the per 100,000 capita supply of chiropractors and primary care physicians according to the 306 predefined Hospital Referral Regions. Multiple variable Poisson regression was used to examine the influence of population characteristics on the supply of both practitioner-types.

Results

According to these data, there are 74,623 US chiropractors and the per capita supply of chiropractors varies more than 10-fold across the nation. Chiropractors practice in areas with greater supply of primary care physicians (Pearson’s correlation 0.17, p-value < 0.001) and appear to be more responsive to market conditions (i.e. more heavily influenced by population characteristics) in regards to practice location than primary care physicians.

Conclusion

These findings suggest that chiropractors practice in areas of greater primary care physician supply. Therefore chiropractors may be functioning in more complementary roles to primary care as opposed to an alternative point of access.

Keywords:
Chiropractic; Supply; Distribution; Health resources; Manpower