What's Holding Chiropractic Back?
A recent study was released in Britain by the National Association of Health Authorities and Trusts (NAHAT).1 The research paper, "Complementary Therapies in the NHS" (National Health Service) discussed the prospect of various therapies (chiropractic et al.) being included in Britain's national health care.
The three primary segments of the health care system were included in the study: District Health Authorities (DHAs), General Practitioner Fund Holders (GPFHs), and Family Health Service Authorities (FHSAs). When asked for their views on whether chiropractic care should be included in the NHS, they responded:
DHAs - Yes 47% - No 21% - Don't Know 29%
FHSAs - Yes 63% - No 7% - Don't Know 25%
GPFHs - Yes 53% - No 21% - Don't Know 12%
While a clear majority were in favor of inclusion of chiropractic in the NHS, certainly a encouraging tabulation, the percentage in the "don't know" category are troubling.
When asked for the "factors important to decision making on complementary therapies," this was the response:
DHAs
Lack of information on effectiveness 66% Lack of resources 24% Lack of demand 20% Other priorities 14% Lack of information/knowledge 14% Demand by GPs/public 10% High cost 8% Professional skepticism 8%
GPFHs
Lack of information on effectiveness 48% Lack of information/knowledge 36% Lack of resources 31% Patient demand 16% Low priority 7% Lack of DHA provision 7%
FHSAs
Lack of information on effectiveness 59% Lack of information/knowledge 25% Lack of resources 25% Public/GP opinion 20% Lack of information re: quality/training 17% Lack of demand from GP/public 13% Lack of support from GPs 13% Low priority 11%
Clearly, lack of information, particularly on effectiveness, is the deciding factor for the inclusion of chiropractic and other alternative forms of health care in the NHS. This was part of the conclusion:
"Before any rational decisions can be taken about complementary therapies, their effectiveness and appropriate uses need to be determined. A critical review of all available evidence on the effectiveness of complementary therapies needs to be undertaken by credible and independent researchers with experience in assessing effectiveness information. The reviews should include 'scientific' research studies, holistic research and anecdotal reports and the findings should be widely disseminated."
The conclusions of this report are most likely not isolated to health care in Great Britain. Chances are that in every country, chiropractic is experiencing the same lack of credibility due to lack of information.
The ability of the chiropractic profession to fund viable research, published it in refereed, indexed journals, and to then disseminate it, will determine chiropractic's inclusion in health care. Lack of information equals lack of inclusion.
1. Cameron-Blackie G: Complementary therapies in the NHS. London: Nat'l Assoc. of Health Authorities and Trusts. Radcliffe Medical Press, Oxford, 1993.
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