The General Chiropractic Council’s (GCC) Registrant Survey 2020 was conducted in September and October 2020. Its aim was to gain valuable insights into the chiropractic profession to improve the GCC’s understanding of chiropractic professionals’ work and settings, qualifications, job satisfaction, responsibilities, clinical practice, future plans, the impact of the COVID-19 pandemic on practice, and optimism and pessimism about the future of the profession.
The survey involved a census of chiropractors registered with the GCC. It was administered online, with an invitation email was sent to every GCC registrant, followed by three reminders for those that had not responded to the survey. An open-access online survey was also available for registrants to complete if they did not respond to the mailings. This was promoted using the GCC website and social media channels. In total, 3,384 GCC registrants were eligible to take part in the survey. A fairly miserable response rate of 28.6% was achieved.
Here are 6 results that I found noteworthy:
- Registrants who worked in clinical practice were asked if performance was monitored at any of the clinical practices they worked at. Just over half (55%) said that it was and a third (33%) said it was not. A further 6% said they did not know and 6% preferred not to say. Of those who had their performance monitored, only 37% said that audits of clinical care were conducted.
- Registrants working in clinical practice were asked if any of their workplaces used a patient safety incident reporting system. Just under six in ten (58%) said at least one of them did, whilst 23% said none of their workplaces did. A further 12% did not know and 7% preferred not to say.
- Of the 13% who said they had a membership of a Specialist Faculty, a third (33%) said it was in paediatric chiropractic, 25% in sports chiropractic, and 16% in animal chiropractic. A further 13% said it was in pain and the same proportion (13%) in orthopaedics.
- Registrants who did not work in chiropractic research were asked if they intended to work in that setting in the next three years. Seven in ten (70%) said they did not intend to work in chiropractic research in the next three years, whilst 25% did not know or were undecided. Only 5% said they did intend to work in chiropractic research.
- Registrants were also asked how easy it is to keep up to date with recommendations and advances in clinical practice. Overall, two-thirds (67%) felt it was easy and 30% felt it was not.
- Registrants were asked in the survey whether they felt optimistic or pessimistic about the future of the profession over the next three years. Overall, half (50%) said they were optimistic and 23% were pessimistic. A further 27% said they were neither optimistic nor pessimistic.
Perhaps even more noteworthy are those survey questions and subject areas that might have provided interesting information but were not included in the survey. Here are some questions that spring into my mind:
- Do you believe in the concept of subluxation?
- Do you treat conditions other than spinal problems?
- How frequently do you use spinal manipulations?
- How often do you see adverse effects of spinal manipulation?
- Do you obtain informed consent from all patients?
- How often do you refer patients to medical doctors?
- Do you advise in favour of vaccinations?
- Do you follow the rules of evidence-based medicine?
- Do you offer advice about prescribed medications?
- Which supplements do you recommend?
- Do you recommend maintenance treatment?
I wonder why they were not included.
I would have like the question asked:
“Why did you become a chiropractor and not a physiotherapist, nurse, or medical doctor?”
Perhaps next time?
Almost like the question posed to Debbie McKee: “What first attracted you to millionaire Paul Daniels?” – but rather:
“What first attracted you to a profession which appears easy to enter, requires no critical thinking, places minimal reliance on plausible reproducible evidence of benefit, encourages pretence of in-depth medical knowledge and takes advantage of patients who are ignorant of claims about ‘subluxations’, ‘vital forces’, and ‘innate intellegence’?
Such a good point.
A 2019 survey of US chiropractors showed that more than 94% came to chiropractic either through a referral from a chiropractor (31.4%) or from personal experience with chiropractic (62.9%):
Ref: https://www.chiroeco.com/best-chiropractic-colleges/
How many would of them would have understood that personal experience is a dubious method of measuring the outcome of a health intervention – e.g. https://tinyurl.com/3v2tuahr ?
Prof. Ernst wrote: “Perhaps even more noteworthy are those survey questions and subject areas that might have provided interesting information but were not included in the survey. Here are some questions that spring into my mind: Do you believe in the concept of subluxation?…”
It’s worth taking a very close look at the UK General Chiropractic Council’s (GCC) view of the (mythical) ‘Vertebral Subluxation Complex’:
In May of 2010, it advised that “The chiropractic Vertebral Subluxation Complex (VSC) is not supported by any clinical research evidence that would allow claims to be made that it is the cause of disease or health concerns.”
Ref: https://tinyurl.com/ufpzcz29
However, in August 2010, the *vitalistic* Alliance of UK Chiropractors (AUKC), which claims to be the largest of the four UK chiropractic associations, produced this statement:
QUOTE
“On 17th August we met with the GCC and presented a dossier [full document here https://tinyurl.com/5yazzy8k ] on the VSC. After reviewing this document, and discussions that followed at this meeting, the GCC agreed that they would delete the phrase ‘or health concerns’ in the VSC guidance and provide an explanation why it had done so…”
Ref. https://www.zenosblog.com/wp-content/uploads/2010/11/AUKC_Oct_Newsletter.pdf
Perhaps not surprisingly, the GCC provided no evidence in support of its consequent U-turn. This is evidenced by a letter to a member of the public on 26th August 2010:
https://tinyurl.com/y67h5qyq
Currently, GCC guidance appears to continue to imply that the VSC can cause ‘health concerns’ via the omission of both words:
Ref. https://tinyurl.com/y5bfnlev
This stance is utterly confusing to the public and chiropractic customers because it leaves the door open for hundreds UK chiropractors to continue to ‘treat’ a broad scope of health problems. Undoubtedly they are also helped by the many dozens of bamboozling terms that either relate to, are synonyms for – or have been used or cited in connection with -describing a subluxation or aspects of a VSC. They were listed by P. L. Rome, one of the co-authors of the dossier mentioned above, and can be read here:
https://edzardernst.com/2015/01/my-visit-to-the-anglo-european-college-of-chiropractic/#comment-63772
What is unacceptable, IMO, is that the GCC will be wholly aware of the dubious practice styles of a many of its registrants since a recent Professional Standards Authority Performance Review of the GCC revealed that there were at least 1000 *declared* vitalist/subluxation-based chiropractors (AUKC members) in the UK. See 5.14 here:
https://www.professionalstandards.org.uk/docs/default-source/publications/performance-review—gcc-2015-16.pdf?sfvrsn=268d7020_0