Overview of size, composition and role

Overview of group

Description of professionChiropractic is a health-care discipline based on the scientific premise that the body is a self-regulating, self-healing organism. These important functions are controlled by the brain, spinal cord, and all the nerves of the body. The practice of chiropractic focuses on the relationship between structure (primarily the spine and pelvis) and function (as coordinated by the nervous system) and how that relationship affects the preservation and restoration of health. Chiropractic also places an emphasis on nutrition, exercise, wellness and healthy lifestyle modifications. Chiropractors manage chronic and acute conditions. They do not prescribe drugs or perform surgical procedures, although they do refer patients for these services if they are medically indicated.
Number4,300 (CAA membership)

(2006 Census recorded 2,485)

Gender mix33% female, 67% male

EXHIBIT 42 - Distribution by Age and State

Distribution by age and location - chiropractorsD

EXHIBIT 43 - Overview of practice attributes

Overview of respondent practice attributes for chiropractorsD

Education, registration and accreditation

  • Successful completion of a 5 year university degree program is a pre-requisite for registration. (The degree program must be accredited by the Council on Chiropractic Education Australasia).
  • In order to be eligible to register with Medicare, Chiropractors must be registered with the Chiropractic Board of Australia, which is one of the national boards established under NRAS.
  • After entering practice, and as a compulsory pre-requisite for ongoing registration, all registered chiropractors must complete continuing professional development in line with the requirements set by the Chiropractic Board of Australia.

Funding and referral system

  • The majority of chiropractors operate predominantly in private practice, for which fee-for-service is charged. Rebates are available from the private health insurance funds.
  • Eligible Chiropractors can access Medicare on referral from a GP through the individual allied health items for people with a chronic or terminal medical condition and complex care needs (MBS items 10950-10970); and the follow-up allied health items for people of Aboriginal or Torres Strait Islander descent (MBS items 81300-81360).

Peak National Body

Chiropractors' Association of Australia
Address2/36 Woodriff Street,
Penrith NSW 2750
ContactTelephone: +61 (2) 4731 8011 or
1800 075 003

Facsimile: +61 (2) 4731 8088

E-mail: caa@caa.asn.au

Chiropractors and eHealth

Examples of relevant eHealth applications

The key uses of eHealth that chiropractors will benefit from include:
  • Electronic patient education resources – a large amount of educational information is commonly conveyed to patients electronically, either online or through DVDs.
  • Digital image transfer and storage – the storage requirements for plain films which must be kept for medicolegal purposes are driving uptake of these applications amongst many chiropractors.
  • Patient behaviour monitoring – recently a mobile telephone application for iphones and Google android has been developed called ‘Just Start Walking’.11 It converts your mobile into an electronic pedometer. Supported by a national education campaign conducted by the CAA on the importance of posture and regular exercise, uptake of the application has reportedly been very high.
  • Electronic health records – only a minority of chiropractors are using an electronic health record, however the rates are increasing quite rapidly, particularly for new graduates.
  • Digital referrals and patient histories – automate aspects of taking patient history so that the chiropractor can spend more time with the patient addressing actual problems rather than duplicating histories and data entry.

Current eHealth 'Position'

Chiropractors aged under 50 tend to be highly technically competent, with those aged over 50 slightly slower in their adoption of new technologies. 60% are currently using email to access educational material and journals from the CAA.

There are about 3 or 4 software programs targeted at chiropractors, however a number of individual practices have gone ahead and designed or customised their own systems, the reason for this is unclear.

The proposed PCEHR has had a mixed response from chiropractors. On one hand the access to a patient’s past medical history is considered clinically useful. On the other hand the profession is wary of scrutiny of its style of record-keeping by other health professionals due to the perception that its holistic philosophy of patient care is generally poorly understood. They are also concerned about the confidentiality issues around records given the personal information provided by the patient due to chiropractors’ client-centred and bio-psychosocial approach to clinical care.

Key insights from eHealth readiness survey

  • Chiropractors are the youngest of the allied health professions (30% under 35 years of age), see high patient volumes (32% see more than 25 patients per day) and rarely practice in remote locations (83% never work in a rural or remote location)
  • Chiropractors’ leading uses of computers are administrative, including billing and patient rebates (76%) and patient booking and scheduling (76%). Educational tools are also widely used (59% have adopted online clinical reference tools, while 30% have not, but would like to; 56% use online CPD materials, and 31% have not, but would like to).
  • For many other potential uses of eHealth, Chiropractors have not yet adopted as much as they would like. Leading examples include viewing and ordering diagnostic imaging (30% and 12% respectively use, but a further 52% and 65% don’t use, but would like to).
  • Communicating with patients is also sought-after (32% use, while a further 47% would like to), as well as showing patients health-related information (37% use, a further 41% would like to). Referrals, sharing records with other practitioners and recording patient information show a similar latent need.
  • Chiropractors rarely use telehealth (9% currently use) and see only minor applications in the near future (19% expect to be using within 3 years). Interest is strongest in training (12%) and collaborating with other practitioners (11%).
  • 36% of chiropractors rely solely on paper records. Of the remaining 64%, just 41% use an EHR. Chiropractors have the lowest expectation of computer use amongst allied health practitioners, with 17% suggesting they are expected to use computers, and 28% agreeing that most of their colleagues use computers.
  • The leading perceived benefits for chiropractors include indicators of provision and quality of care, including improving collaboration (21% strongly agree) and improving continuity of care (11%). Business efficiency also registers strongly, for example improving practice efficiency (16% strongly agree) and increasing number of referrals (9%). Potential benefits for patient relationships and engagement do not resonate for chiropractors, for example just 5% strongly agree eHealth could help improve patient relationships.
  • Chiropractors have reasonable access to computer and connectivity infrastructure (approximately 80% have access across major city, inner and outer regional practices) but those practicing in remote areas have very low access (29% have computers, 56% have internet access).
  • The strongest barriers for chiropractors include concerns about malfunction and downtime (35% strongly agree), the visibility of practitioner performance data (31%), and affordability (30%).
  • Chiropractors listed their top drivers of adoption as financial incentives (29% strongly agree) and the advice of their professional body (24%).

11<http://www.juststartwalking.com.au/> (accessed 16 May 2011).