Attitudes Towards Chiropractic: A Repeated Cross-Sectional Survey of Canadian Family Physicians 

Abstract

Background: Attitudes of Canadian family physicians towards chiropractic are uncertain. Methods: A 50-item survey administered to a ranmdom sample of Canadian family physcians in 2010, and again in 2019, that inquired about demographic variables, knowledge and use of chiropractic. Imbedded in our survey was an 80-point chiropractic attitude questionnaire (CAQ); higher scores indicated more positive attitudes toward chiropractic. Results: Among eligible physicians, 251 of 685 in 2010 (37% response rate) and 162 of 2,429 in 2019 (7% response rate) provided a completed survey. Approximately half of respondents (48%) endorsed a positive impression of chiropractic, with 27% expressing uncertainty and 25% holding negative views. Most respondents (72%) referred patients for chiropractic care, mainly due to patient request or lack of response to medical care. Most physicians believed that chiropractors provide effective therapy for some musculoskeletal complaints (84%) and disagreed that chiropractic care was beneficial for non-musculoskeletal conditions (77%). The majority agreed that chiropractic care was a useful supplement to conventional care (65%) but most respondents (59%) also indicated that practice diversity within the chiropractic profession presented a barrier to interprofessional collaboration. In our adjusted regression model, attitudes towards chiropractic showed trivial improvement from 2010 to 2019 (0.31 points on the CAQ; 95%CI 0.001 to 0.62). More negative attitudes were associated with older age (-1.55 points for each 10-year increment from age 28; 95%CI -2.67 to -0.44), belief that adverse events are common with chiropractic care (-1.41 points; 95% CI -2.59 to -0.23) and reported use of the research literature (-6.04 points; 95% CI -8.47 to -3.61) or medical school (-5.03 points; 95% CI = -7.89 to -2.18) as a source of knowledge on chiropractic. More positive attitudes were associated with endorsing a relationship with a specific chiropractor (5.24 points; 95% CI 2.85 to 7.64), family and friends (4.06 points; 95% CI 1.53 to 6.60), or personal treatment experience (4.63 points; 95% CI 2.14 to 7.11) as sources of information regarding chiropractic.Conclusions: Although generally positive, Canadian family physicians’ attitudes towards chiropractic are diverse, and most physicians acknowledge that practice diversity within the chiropractic profession presents a barrier to interprofessional collaboration.